Healing Combat Trauma

Quotable Quotes -- American Poet Walt Whitman on the True Nature of War

Famous American poet Walt Whitman (1819 - 1892), author of "Leaves of Grass," volunteered as a nurse in the Civil War. He is reported to have been profoundly affected by what he saw, and wrote about it in an essay called "The Great Army of the Sick," published in a New York newspaper at the time, and also in a later book called "Memoranda During the War." He claims to have visited almost 100,000 wounded troops, though that claim is likely to be an exaggeration, and is thought to have sat at many wounded soldiers' bedsides, drafting letters home for them to their loved ones, among many other kindnesses he performed.

In the tone of Vietnam combat veteran Tim O'Brien who wrote "The Things We Carried," who famously said, "A true war story is never moral," Whitman wrote, "The real war will never get in the books."

Whitman had originally journeyed to find his injured brother, George, who had enlisted with the Union Army, traveling to battlegrounds and eventually to hospitals in Washington, D.C. Along the way he wrote his mother, tellingly:

"Now that I have lived for eight or nine days amid such scenes as the camps furnish … really nothing we call trouble seems worth talking about.”

Editor's note: This photo of Walt Whitman during his Civil War years is by the famous photographer Matthew Brady, and is in the archives of the Library of Congress. A collection of his work in the National Archives, online, is linked here.

Quotable Quotes -- Eleanor Roosevelt on the Human Cost of War

As a nation, we've been blessed to have had some wonderfully enlightened presidents -- and in this case, first ladies as well. (See previous quotes by Eisenhower on war, etc.) But in this case, we've got the prayer that Eleanor Roosevelt apparently carried around in her pocket during World War II, to highlight the sacred responsibilty of sending others off to war. It's both profound and true. Here's what it said:

"Dear Lord,

Lest I continue
My complacent way
Help me to remember
Somehow out there
A man died for me today.
As long as there be war
I then must
Ask and answer
Am I worth dying for?"

Unlike in Roosevelt's World War II era, where almost 25% of the nation served -- today just about 1% of the nation does. That means that hardly anyone understands the cost of war or the sacrifices military families make except those who serve and so have "skin in the game." This prayer is probably more relevant now that ever.

Editor's note: Illustration is the White House portrait of Mrs. Roosevelt.

Karl Menninger, M.D. on PTSD (Combat Stress) in WWII Veterans

We've briefly quoted Karl Menninger, M.D., before, here. But in scouring a book he wrote almost 50 years ago, we came across this extensive retelling of what he observed with World War II veterans and combat stress -- what we know today as PTSD.

It's interesting to read because there is both not much material readily available before the Vietnam War brought post-traumatic stress disorder into the common awareness, and also because the phenomenon of PTSD does seem to slightly "mutate" over time, perhaps because of the difference in the types of combat with each significant war. Menninger, a world-famous psychiatrist, brings up many important points in this passage -- and we wonder how many of them would still be considered true today.

(The context for the original work that he's citing here was performed when he was a member of a commision to study combat exhaustion in World War II veterans, appointed by the Surgeon General and his brother, Brigadier-General William C. Menninger.)

“In our studies of reactions to combat stress in World War II previously referred to, we were very much impressed with the way in which a set of forces began a phase of great stress and simultaneously aroused certain opposing forces which helped to maintain a balance. Then came more stress and more defense. Gradually the stresses seemed to become greater than the defenses, so that there occurred a lowering of achievement level, a partial retreat, the employment of emergency regulatory devices, evidences of threatened disorganization, and then, usually a recourse to medical aid.

With sedation and a few hours of rest many of these individuals were able to resume their former efficiency and return to the battle. Heroic and admirable as it was, this was not too difficult to explain. But other individuals had the same treatment and were not able to return to the front lines. Their symptoms persisted. This too we could understand. More time was required, more rest, more recuperation, further removal from the imminence of renewed combat stress.

But now comes the enigma. Many of these patients were sent back to the base hospital for care, nursing, protection, rest, and treatment. We saw some of them there, later. Many had improved or were improving; some had returned to duty (but usually not to combat duty). What impressed us most was that some of them were not better; they were under treatment of sorts, but they were worse. There was, for them, no more battle stress, no more physical exertion and prevail, no more threat of death. There was not even any considerable probability of further duty assignment. Bright, or at least safe and comfortable, situations lay ahead for them. Why did not the symptoms disappear?

In analyzing the nature of the stress they had undergone, we began to realize this was different from what would appear on the surface. In the beginning these men had experienced fear, fatigue, resentment, hunger, cold, and other things. But they were sustained, there, by many things, too: self-respect, pride-idealism, courage, devotion to duty, training, and habituation to routine. Moreover, there was a strong support from relations with comrades and officers and units. The sudden increment of stress which precipitated these symptoms was frequently the loss of one of these human supports by death or transfer. In other instances cumulative fatigue seemed to be the most important factor.

For these men, then, who did not respond to battalion aid-station treatment, the nature of the stress had changed; but it did not diminish quantitatively as the casual observer might have assumed. The threat of danger was gone, true, but so were the excitement and the routine activity. The weariness was gone, true, but so was the companionship of fellow soldiers. The unpleasant physical conditions were corrected, but in their place was the guilt feeling of abandoning one’s comrades and the fear of accusation of cowardice. Painfully disturbing was the dilemma that if one mastered his distress he would be sent back to duty, but if one admitted it he would be retired. A retirement could be cleared of all tincture of suspected cowardice only if it took the form of something called sickness. Efficient warfare and humane medical science are antithetical and sooner or later the antithesis shows up in the individual.”

-- Karl Menninger, M.D., “The Vital Balance: The Life Process in Mental Health and Illness.” New York: The Viking Press (1963).

Editor's note: The photo illustrates Polish soldiers involved in the Warsaw Uprising.

A Remarkable Quote from General Dwight D. Eisenhower about Who PTSD Affects

"You mustn't think of these people as just some sort of unfortunates . . . They are not — they are one of you. I saw a major general, one of the finest athletes of his time, definitely break — break because he could no longer sustain the agonies of combat. He could not talk to me without shaking, and he had to go home. This cannot be dismissed as not touching you personally." -- General Dwight D. "Ike" Eisenhower, U.S. president and five-star Army general.

Quotable Quotes -- Chief Dan George on the Necessity of Love

It's not always easy to love a combat veteran with PTSD. Heck, it's not even easy to BE a combat veteran with PTSD and manage to love yourself, or those around you the way that you want to.

But part of healing is getting back in touch with how important love is, and even respecting its own form of therapeutic, healing power. Listen to these words from a very wise sage about just how important love is, in the natural order of things:

"Love is something you and I must have. We must have it because our spirit feeds upon it. We must have it because without it we become weak and faint. Without love our self-esteem weakens. Without it our courage fails. Without love we can no longer look out confidently at the world." -- Chief Dan George, Canadian First Nations chief, poet, author and Academy Award-winning actor.

Martin Luther King Jr Had a Dream for Combat Veterans, Too

Martin Luther King Jr., from a speech delivered exactly one year before he was assassinated in Memphis, Tenn.:

"This business of burning human beings with napalm, of filling our nation's homes with orphans and widows, of injecting poisonous drugs of hate into veins of peoples normally humane, of sending men home from dark and bloody battlefields physically handicapped and psychologically deranged, cannot be reconciled with wisdom, justice and love." -- Martin Luther King Jr, speech at Riverside Church in New York City, April 4, 1967. 

Editor's note: A link to the online text and audio of his full speech is here.

Quotable Quotes -- Helen Keller on Suffering Refining Character

It's not easy to find any true benefit to suffering, but occasionally, a wise person offers some. Here's what Helen Keller -- someone who surely endured much of what the rest of us would consider suffering -- had to say:

"Character cannot be developed in ease and quiet. Only through experience of trial and suffering can the soul be strengthened, ambition inspired, and success achieved." -- Helen Keller.

Quotable Quotes -- Smedley Butler, Maverick Marine, on the True Costs of War to Veterans and Their Families

USMC Major General Smedley Butler wrote a remarkable and well-known piece of work called "War is a Racket," originally delivered as a stinging speech. In it, he takes the war profiteers of World War I and beyond to task for forgetting who it is who fights the battle, and who bears the ultimate price of war. His words are, of course, as relevant today as they ever were. In fact, it's intriguing to read his words and quiz ourselves how alike -- or different -- are conditions today.

So many people want to say, "Oh, we're just finding out about PTSD, that's why the system lags behind in treating vets." But in fact, this is not the case at all. The phenomenon of combat-wounded bodies, minds and spirits has been around as long as there's been war, irrespective of what name we've used to describe the malady. "Shell shock"? "Soldier's Heart"? "Post-Traumatic Stress"? Ultimately, it's all the same thing. And documentaries from "Hidden Wounds" and "The Soldier's Heart" back in 2006, which I wrote about here almost five years ago now, to HBO's recent "Wartorn" all make this point quite eloquently.

But back to Smedley Butler, a two-time Medal of Honor winner who served more than 33 years on active duty in the Marine Corps. Here's a sampling of his direct comments on what happens to the wounded and their families, and we quote it at length because there's just so much material here to really chew over and decide how "new" the struggles we're facing really are, re-integrating veterans after combat. His words:

"But the soldier pays the biggest part of the bill.

If you don't believe this, visit the American cemeteries on the battlefields abroad. Or visit any of the veteran's hospitals in the United States. On a tour of the country, in the midst of which I am at the time of this writing, I have visited eighteen government hospitals for veterans. In them are a total of about 50,000 destroyed men -- men who were the pick of the nation eighteen years ago. The very able chief surgeon at the government hospital; at Milwaukee, where there are 3,800 of the living dead, told me that mortality among veterans is three times as great as among those who stayed at home.

Boys with a normal viewpoint were taken out of the fields and offices and factories and classrooms and put into the ranks. There they were remolded; they were made over; they were made to "about face"; to regard murder as the order of the day. They were put shoulder to shoulder and, through mass psychology, they were entirely changed. We used them for a couple of years and trained them to think nothing at all of killing or of being killed.

Then, suddenly, we discharged them and told them to make another "about face" ! This time they had to do their own readjustment, sans [without] mass psychology, sans officers' aid and advice and sans nation-wide propaganda. We didn't need them any more. So we scattered them about without any "three-minute" or "Liberty Loan" speeches or parades. Many, too many, of these fine young boys are eventually destroyed, mentally, because they could not make that final "about face" alone.

In the government hospital in Marion, Indiana, 1,800 of these boys are in pens! Five hundred of them in a barracks with steel bars and wires all around outside the buildings and on the porches. These already have been mentally destroyed. These boys don't even look like human beings. Oh, the looks on their faces! Physically, they are in good shape; mentally, they are gone.

There are thousands and thousands of these cases, and more and more are coming in all the time. The tremendous excitement of the war, the sudden cutting off of that excitement -- the young boys couldn't stand it.

That's a part of the bill. So much for the dead -- they have paid their part of the war profits. So much for the mentally and physically wounded -- they are paying now their share of the war profits. But the others paid, too -- they paid with heartbreaks when they tore themselves away from their firesides and their families to don the uniform of Uncle Sam -- on which a profit had been made. They paid another part in the training camps where they were regimented and drilled while others took their jobs and their places in the lives of their communities. The paid for it in the trenches where they shot and were shot; where they were hungry for days at a time; where they slept in the mud and the cold and in the rain -- with the moans and shrieks of the dying for a horrible lullaby.

But don't forget -- the soldier paid part of the dollars and cents bill too.

Up to and including the Spanish-American War, we had a prize system, and soldiers and sailors fought for money. During the Civil War they were paid bonuses, in many instances, before they went into service. The government, or states, paid as high as $1,200 for an enlistment. In the Spanish-American War they gave prize money. When we captured any vessels, the soldiers all got their share -- at least, they were supposed to. Then it was found that we could reduce the cost of wars by taking all the prize money and keeping it, but conscripting [drafting] the soldier anyway. Then soldiers couldn't bargain for their labor, Everyone else could bargain, but the soldier couldn't.

Napoleon once said,

"All men are enamored of decorations . . . they positively hunger for them."

So by developing the Napoleonic system -- the medal business -- the government learned it could get soldiers for less money, because the boys liked to be decorated. Until the Civil War there were no medals. Then the Congressional Medal of Honor was handed out. It made enlistments easier. After the Civil War no new medals were issued until the Spanish-American War.

In the World War, we used propaganda to make the boys accept conscription. They were made to feel ashamed if they didn't join the army.

So vicious was this war propaganda that even God was brought into it. With few exceptions our clergymen joined in the clamor to kill, kill, kill. To kill the Germans. God is on our side . . . it is His will that the Germans be killed.

And in Germany, the good pastors called upon the Germans to kill the allies . . . to please the same God. That was a part of the general propaganda, built up to make people war conscious and murder conscious.

Beautiful ideals were painted for our boys who were sent out to die. This was the "war to end all wars." This was the "war to make the world safe for democracy." No one mentioned to them, as they marched away, that their going and their dying would mean huge war profits. No one told these American soldiers that they might be shot down by bullets made by their own brothers here. No one told them that the ships on which they were going to cross might be torpedoed by submarines built with United States patents. They were just told it was to be a "glorious adventure."

Thus, having stuffed patriotism down their throats, it was decided to make them help pay for the war, too. So, we gave them the large salary of $30 a month.

All they had to do for this munificent sum was to leave their dear ones behind, give up their jobs, lie in swampy trenches, eat canned willy (when they could get it) and kill and kill and kill . . . and be killed.

But wait!

Half of that wage (just a little more than a riveter in a shipyard or a laborer in a munitions factory safe at home made in a day) was promptly taken from him to support his dependents, so that they would not become a charge upon his community. Then we made him pay what amounted to accident insurance -- something the employer pays for in an enlightened state -- and that cost him $6 a month. He had less than $9 a month left.

Then, the most crowning insolence of all -- he was virtually blackjacked into paying for his own ammunition, clothing, and food by being made to buy Liberty Bonds. Most soldiers got no money at all on pay days.

We made them buy Liberty Bonds at $100 and then we bought them back -- when they came back from the war and couldn't find work -- at $84 and $86. And the soldiers bought about $2,000,000,000 worth of these bonds!

Yes, the soldier pays the greater part of the bill. His family pays too. They pay it in the same heart-break that he does. As he suffers, they suffer. At nights, as he lay in the trenches and watched shrapnel burst about him, they lay home in their beds and tossed sleeplessly -- his father, his mother, his wife, his sisters, his brothers, his sons, and his daughters.

When he returned home minus an eye, or minus a leg or with his mind broken, they suffered too -- as much as and even sometimes more than he. Yes, and they, too, contributed their dollars to the profits of the munitions makers and bankers and shipbuilders and the manufacturers and the speculators made. They, too, bought Liberty Bonds and contributed to the profit of the bankers after the Armistice in the hocus-pocus of manipulated Liberty Bond prices.

And even now the families of the wounded men and of the mentally broken and those who never were able to readjust themselves are still suffering and still paying."

-- Smedley Butler, "War is a Racket." (1935).

Editor's note: You can read "War is a Racket" in full at several places on the Web. It's well worth reading. And, if you'd rather hear key parts of it delivered as a speech, which was its original form, check out this link from YouTube.

Quotable Quotes -- William Gladstone on the Nation's Care for Its Dead

"Show me the manner in which a nation cares for its dead, and I will measure with mathematical exactness the tender mercies of its people, their respect for the laws of the land and their loyalty to high deeds." -- William E. Gladstone, former British prime minister.

Quotable Quotes -- Carl Jung on Only the Wounded Physician Heals

"The doctor is effective only when he himself is affected. Only the wounded physician heals." -- Carl Jung.

Quotable Quotes -- Dwight D. Eisenhower on the How the Soldier Hates War

We've quoted former president Eisenhower before on this site, here, but this is another good quote, from a man who knew:

"I hate war as only a soldier who has lived it can, only as one who has seen its brutality, its futility, its stupidity." -- Dwight D. Eisenhower, U.S. president and Army five star general.

Quotable Quotes -- Washington Irving on What Tears Really Are

“There is a sacredness in tears. They are not the mark of weakness, but of power. They speak more eloquently than ten thousand tongues. They are messengers of overwhelming grief...and unspeakable love.” -- Washington Irving

 

 

The Color of Blood, and the Eternal Reciprocity of Tears

Wilfred Owen, a veteran of World War I, died at 25 years old, shortly before the Armistice was announced. (Armistice Day became Veterans Day, which we just celebrated.)

Before Owen died, he had been seriously wounded in combat, hospitalized, and then diagnosed with the era-appropriate term for post-traumatic stress, which was "shell shock."

While in the hospital, he met fellow poet Siegfried Sassoon. Robert Graves, another important British literary figure and veteran, wrote "Wet Bond of Blood," describing the relationship among combat veterans, for Sassoon. (We wrote about that poem several years ago, in an item linked here.) All three men -- Owen, Graves and Sassoon -- fought in World War I and all three of them suffered from what we now know as PTSD. Owen used his time in the hospital to write many of the poems that later made him famous.

There's a terrible/beautiful one called "Insensibility," whose phrases speak powerfully of combat, loss and numbness. A few key lines, pulled out of sequence so we can sense their evocative power, are those selected below. Think about how much they relate to veterans today. Combat and its effects, including PTSD, are timeless. The HBO documentary, Wartorn, just released makes that point powerfully by following individual soldiers' unraveling after combat from the Civil War to the present. But Owen's poem also covers some of the same ground. A few lines in particular stand out:

 

"Happy are men who yet before they are killed

Can let their veins run cold."

---

"And some cease feeling

Even themselves or for themselves."

---

"Happy are these who lose imagination:

They have enough to carry with ammunition.

Their spirit drags no pack.

Their old wounds, save with cold, can not more ache.

Having seen all things red,

Their eyes are rid

Of the hurt of the colour of blood forever."

---

And the closing lines, about men ("dullards") who never fought, but feel nothing for those who died:

---

"By choice they made themselves immune

To pity and whatever moans in man

Before the last sea and the hapless stars;

Whatever mourns when many leave these shores;

Whatever shares

The eternal reciprocity of tears."

 

Editor's note: For more about famous WWI poet, Wilfred Owen, click here. For a selection of Owen's poems, all about war, online, click here. For the full text of Owen's poem, "Insensibility," referenced above, click here.

Quotable Quotes -- Shakespeare on the Sacred Blood Brotherhood of Combat

Echoing the sentiments of combat veterans from every era, Shakespeare wrote in his play, Henry V, "For he today that sheds his blood with me shall be my brother tomorrow."

Editor's note: For more on the "wet bond of blood" brotherhood of combat, click here or here. There is much more to say on this subject.

Quotable Quotes -- Harry Truman on the Disposable Nature of War Heroes

U.S. president Harry S. Truman, who'd also served in World War I as an artillery officer, wrote privately to his wife, Bess, in 1936 something telling about the transitory nature of being a war hero. He points out how disposable the "hero" label can be, or how short-term people's attention really is. World War I was over, and World War II had yet to start, but he observed that:

"War heroes are no longer that. They are now looked upon as a sort of nuisance and are considered fools to have gone." 

(It brings to mind the Bill Mauldin cartoon where his heroes, Army buddies Willie and Joe, visit the hospital bed of a fellow WWII veteran who is recuperating from his war wounds. The injured soldier asks his buddies, "How's things outside, boys? Am I still a war hero, or a drain on th' taxpayer?")

(The photo below right is of Truman in his WWI uniform.)

Quotable Quotes -- Michel de Montaigne on Valor of the Soul

We usually think of "valor" according to its dictionary definition -- "strength of mind or spirit that enables a person to encounter danger with firmness; personal bravery" -- the word itself comes from the Latin word, "valere" -- to be of worth, to be strong, which ultimately became the Middle English word for worthiness or bravery. (We also get the word "value" from these origins.) And on a practical level, we associate the word with the combat action medal, which is given with or without the "V" for valor.

But here's an expanded definition from an influential, 16th century French Renaissance author and statesman. He wrote, more broadly:

"Valor is stability, not of legs and arms, but of courage; of the soul." -- Michel de Montaigne.

Isn't that something that every combat veteran with PTSD -- nay, even every family member, caregiver and loved one of a vet with PTSD -- finds they have to encounter at one time or another? (Rhetorical.) Here's a toast to you in that often-daily struggle to be whole again and to be well.

Quotable Quotes -- Mahatma Gandhi on True Inner Peace

"Each one has to find his peace from within. And peace to be real must be unaffected by outside circumstances." -- Mahatma Gandhi

© 2010 by Lily Casura / Healing Combat Trauma. All rights reserved. Use with attribution.

 

Quotable Quotes -- Heraclitus on the Real Warrior Brings Others Back

"Of every one hundred men, ten shouldn't even be there, 
eighty are nothing but targets, nine are real fighters... 
We are lucky to have them, they make the battle... 
AH but ONE, one of them is a Warrior... 
he will bring the others back." 

-- Attributed to Heraclitus, circa 500 B.C.

When it comes to real warriors with PTSD, who will bring the others back? Rhetorical for now, but it won't stay rhetorical forever... There are ways to improve the condition of a warrior with PTSD. Read more about that here.

© 2010 by Lily Casura / Healing Combat Trauma. All rights reserved. Use with attribution.

 

Quotable Quotes -- Sarah Haley, M.S.W., on Combat's Effect on the Veteran

"Combat veterans may play down or embellish their 'war stories,' but initially their reports should be taken at face value. The only report that should not be accepted at face value, although one may choose not to challenge it initially, is the patient's report that combat in Vietnam had no effect on him." -- Sarah Haley, M.S.W., "When the Patient Reports Atrocities: Specific Treatment Considerations of the Vietnam Veteran," published in Archives of General Psychiatry, Vol. 30, Feb. 1974.

"War Creates Brothers" -- U.S., Afghansti Vets Share Stories, Bond Together

A recent quote from the inimitable Dalai Lama: "To the extent that our experience of suffering reminds us of what everyone else also endures, it serves as a powerful inspiration to practice compassion and avoid causing others pain. And to the extent that suffering awakens our empathy and causes us to connect with others, it serves as the basis of compassion and love."

We've written on the site before about how combat vets "get" what other combat vets go through, and how they share that "wet bond of blood" brotherhood, here and here and many other places as well. (There's even something about it from the Civil War era, here; as well as Ernie Pyle, superstar war correspondent who "got" it, exemplifying it and communicating it from the boys on the front to the families back home, here.) We've started writing lately about "ritual" as a way that "primitive" societies, including sometimes our own, ceremonially bring back in the warrior from the war, embraced by his or her community. The work of Malidoma Somé is impressive as heck; but there are others shortly to speak on this as well, including other veterans who understand it and have lived it, and now want to share it with others.

But if we really want to envision the extent of what the Dalai Lama quote, above, embodies, let's take a look at a cross-cultural, multinational gathering of hard-core combat veterans from more than a decade ago. 

“War Creates Brothers”

U.S., Soviet vets share pasts on Peninsula

By Kevin Patterson

Peninsula Daily Times

Port Angeles – Larry Heinemann doesn’t know the word’s Russian spelling; Igor Zakharov doesn’t speak the English translation. But the word “brat,” which sounds like “brot,” instantly brings the two men together in a shoulder-shaking hug.

“My brat, my brother,” Heinemann explains.

There is much that should separate the two men. Heinemann is 45, an award-winning author, a Vietnam veteran.

Zakharov is 25. A machinist. An Afghansti – a Soviet military veteran who served in Afghanistan.

But they sat side-by-side on a rough cedar-plank bench, sharing American cigarettes and talking about coming home from war. Brothers. Soldiers. Grunts.

American “grunts,” G.I. slang for the everyday soldier, have been coming to this place west of the Elwa River for most of the 1980s. Counselor Bruce Webster has gained national prominence for his role in helping Vietnam veterans re-live their war experiences and confront memories that torment them.

Last weekend, Webster’s beachfront back yard ... became a bivouac for Vietnam vets and a handful of Russian veterans and counselors. It was more fruit from a budding relationship borne of war and government indifference to its warriors.

Heinemann and Zakharov met last December, when a group of Vietnam veterans toured the Soviet Union. Their mission was to make contact with Afghansti , while shunning official government representatives. [Heinemann wrote about his visit in a recent issue of a national magazine.]

“Our welcome by the Afghansti – perhaps 30 men in their early and middle 20s – was profuse, prolonged and astonishingly friendly: hand-shakes and warm smiles and immediate conversation,” Heinemann wrote.

Heinemann said the Vietnam vets saw a lot of ourselves in the young Russian veterans. It is a bond that transcends differences in language, culture and politics.

Afghanistan is often referred to as the Soviets’ Vietnam. It was a part-time war waged in a distant land for ill-defined reasons.

Soviet soldiers who fought in Afghanistan came home to discover that most people did not understand what the army was doing there. The government-controlled news media reported that troops in Afghanistan were there as advisers or to build public works.

Until 1985, soldiers killed in action were sent home in zinc coffins to be buried in secret, Heinemann said. Families often did not know how or where their sons died.

“They call it the false face of welcome,” Heinemann explained. “One man we met said his son might as well have been killed in a bar fight, for all he knew.”

The Vietnam veteran has faced an uphill struggle to win recognition of the scars left by the war. Post-traumatic stress disorder – PTSD – is the living monument to men who fought a senseless war against an enemy who played by different rules.

Heinemann knows about PTSD. His novel, “Paco's Story,” won the 1987 National Book Award. It was a fictional account of a Vietnam vet struggling with PTSD.

Help for veterans has been slow. Complaints about the U.S. government’s response to Vietnam vets are common. So are stories of Vietnam veterans wracked by the awful psychological after-effects of war. People’s understanding of what the war did to some of the soldiers is still evolving.

The Soviet veterans now grapple with some of the same problems, including a government indifference to their needs, Heinemann said. Their 10-year war ended in February, about 16 years after U.S. troops began pulling out of Vietnam.

Heinemann said Vietnam vets know some of what lies ahead for the Afghansti.

“I think that the Afghansti have a chance to save themselves a lot of grief, learning from our mistakes,” Heinemann said. “That’s why I wanted to bring them out here.”

Zakharov sat next to his American comrade, listening to a foreign language and struggling to answer a reporter’s questions.

He served two years in Afghanistan, the usual length of service for Soviet troops. He used a stick to draw 1982-1984, his time in Afghanistan, in the sand and sawdust of the outdoor conversation pit.

Heinemann said Zakharov was with an airborne unit. He was a minesweeper, whose job was to probe for landmines. His navy blue and white –striped undershirt, standard issue for airborne troops, mostly hid the scar he carries from a bullet wound to his left shoulder.

On his right wrist is a red band. The name of a U.S.  Army sergeant, killed in Vietnam, is inscribed there. It’s a memento of his visit to the Vietnam War Memorial in Washington, D.C.

“These are great guys,” Heinemann said. “They’re young and they’re tough and they’ve been through the mill.”

Reprinted with permission of the Peninsula Daily News.

Let Us Now Praise...Vietnam Veterans

Had an amazing "coffee" the other day with Gerald Nicosia, author of the exceptional "Home to War: A History of the Vietnam Veterans' Movement." What I thought would be a quick meet-and-greet with his signing my copy of his remarkable book turned out to be an almost four-hour marathon of information sharing and gathering about the players in his exhaustive, highly-readable record of what went on with the Vietnam veterans' movement. The book took him 12 years to write, went through four publishers, involved 600(!) interviews with participants, and still needed 800 pages cut before its current length, 800 pages in paperback. Remarkable. And it's put me very much in a "Vietnam" frame of mind ever since, following up on threads of what Nicosia talked about in person and remembering yet again how much the Vietnam veterans gave, for so little -- in the way of public acknowledgement and support for their contributions. I always get a little wistful -- even more than a little wistful -- wishing they had so much more recognition for their true generosity of spirit, and character...

So I've been chasing down Memory Lane here -- more Nicosia's than mine -- learning more about some of the Vietnam vets who had such worthwhile points of view, and made such a difference. Some are still alive, some sadly gone before their time.

Ironically, two of the ones who've captured my attention are, not surprisingly, Marines. Marines occupy more than their fair share of this site, maybe because in so many ways they embody the "tip of the spear." They see so much and do so much. Very often idealists, frequently combined with a balls-to-the-walls attitude, they come in for more than their fair share of difficulty. Is their incidence of PTSD higher than other branches? Perhaps. They've done so much for so long with so little they've just learned to live with it, but their numbers seem over-represented in both trying to get some help, and also in trying to do for their fellow veterans, both then and now. (I'll omit the examples here for now, but it's been true in my experience so far that this is the case.)

One of the Vietnam vets I've been trying to learn more about is National Book Award-winning Larry Heinemann, whose quote about war and the veteran's heart we highlighted the other day -- followed by a quote of his wife about the man she married, before and after war.

Another is Jack McCloskey, a Marine medic in Vietnam, who's talked about at length in Nicosia's book, but who died an untimely death at 53 from heart disease, perhaps brought on by both his exposure to Agent Orange and also his tireless work on behalf of other Vietnam vets, not to mention a few bad habits.

Photos of McCloskey are still on the Web, here and here, taken by his longtime friend, Eric Schwartz. And there's a wonderful obituary of him as well, here, though it doesn't talk about how he was shot on the street, and almost killed -- perhaps by someone trying to suppress his activism -- which is mentioned in Nicosia's book. I loved the obituary, and I loved the photos, but more than those, I loved the story conveyed in poetry about who McCloskey really was, and how deeply he loved his fellow veteran. When I read those words, they resonated not "just" about McCloskey -- who I never knew -- but also about another Vietnam vet, Marine, the subject of "Eyewitness to Combat," here -- who's also taken the guns out of the mouths of countless (hundreds? thousands?) of other Vietnam vets, over the years. He's been the one the wives have called, and he's gotten there, mostly, in time -- but not always. Sometimes he's gotten there too late. McCloskey knew that pain himself.

Allen Cohen wrote a poem, "Three Lines and Some Hippy Truths," about McCloskey's death and two others. It should resonate with us today because things aren't very different now. Only a few stand up for the many. "After the war," Cohen writes about McCloskey, "he learned the necessity of healing the mind that survived the broken bodies, and then the souls that were left helpless before the void of meaningless pain. In this way he gave his heart away to the veterans who needed it." From the poem:

Sometimes I get the feeling 
that I'm disappearing behind 
the glaring spotlight of media-
the political circus, TV, 
and Sports, and Movie heroes
In this world of 6 inch and 20 foot tall 
images who do nothing for humanity 
except sell sneakers or make empty speeches,
or appear in the dream world of sex and violence,
and get paid millions of dollars
despite their marginal and illusory existence,
in this world our own lives, 
the lives of those whose acts 
come within the scope of their talents,
their intelligent daily decisions,
their unrewarded kindness and love.
seem to dissolve in frustration and toil
against the silence of the calculus of history.

But look closely at those lives 
with their true heroism of every moment,
fulfilled through the sustenance of friendship,
the love of the children and one another.
For each other they become larger than life, 
far larger than movie screens,
in the singing of a song
the reaching out of a hand across the emptiness,
the drawing of a picture, the writing of a poem
even in the washing of a dish, the repairing 
of a fence or car, the sewing of a loose button.

I am sitting at the memorial for Jack McCloskey,
at the Family Dog Ballroom.
Jack was the Vietnam Veteran counselor
whose life starting in that war
that so defined our era,
was given to reaching out to others.
First to their bodies when as a front line 
unarmed medic, he gave aid to the wounded.
He would overcome the fear of witnessing 
death's witless massacres each time 
he hurled himself into the line of fire.
After the war, he learned
the necessity of healing the mind
that survived the broken bodies,
and then the souls that were left helpless
before the void of meaningless pain.
In this way he gave his heart away
to the veterans who needed it.

There was no People Magazine for Jack McCloskey
No "Jack McCloskey dies News at Eleven."
Country Joe McDonald is playing Sweet Lorraine.
The light show vibrates the air and his friends dance.

Unlikely Bedfellows: Sun Tzu and George Washington on How to Treat Veterans

It's remarkable that through the ages these two leaders and military strategists yet had expressed such a similar thought about the heart behind how to care for veterans. See if you don't agree:

"Regard your soldiers as your children, and they will follow you into the deepest valleys. Look on them as your own beloved sons, and they will stand by you even unto death!" -- Sun Tzu, from his martial classic, "The Art of War"

- and -

"The willingness with which our young people are likely to serve in any war, no matter how justified, shall be directly proportional to how they perceive veterans of early wars were treated and appreciated by our nation." -- George Washington.

Editor's note: Chaplain Kathie Costos, familiar to many as "Nam Guardian Angel," and a true source of wisdom and compassion at her site, Wounded Times and beyond, uses the George Washington line as her email signature, an ever-present reminder of the importance of doing just that.

Quotable Quotes -- Carl Jung on Consciousness and Pain

"There is no coming to consciousness except through pain." -- Carl Jung, Swiss psychotherapist.

(With thanks to Kayla Williams, author of "Love My Rifle More Than You," for a great quote...)

Quotable Quotes -- Dwight D. Eisenhower on Inner and Outer Peace

"There can never be peace between nations until there is first known that true peace which is within the souls of men." -- U.S. president and five star Army general Dwight D. Eisenhower.

Quotable Quotes -- Helen Keller on Overcoming Suffering

"Although the world is full of suffering, it is full also of the overcoming of it." -- Helen Keller

Quotable Quotes -- e.e. cummings on Unbracketing Death

In honor of April being "National Poetry Month," a wonderful excerpt from American poet e.e. cummings (1894-1962) about the continuity of life beyond life. Cummings was no stranger to war and its aftermath: he's one of several famous writers and poets who served as ambulance drivers, in his case, in World War I. This snippet of his poem, "since feeling is first," (Cummings was a big fan of unusual capitalization and punctuation) neatly conveys the impact of a life that goes on past its close, in the memory of the survivors left behind. In the right context, these words offer some small comfort, whether you're thinking about your own legacy, or remembering those you love who've gone before you:

"For life's not a paragraph And death I think is no parenthesis."

Quotable Quotes -- Hippocrates on Healing

"Healing is a matter of time, but is sometimes also a matter of opportunity." -- Hippocrates, the father of Western medicine. (460-377 B.C.E.)

"Not Victims, but Veterans": Max Cleland Writes an Open Letter to Other Combat Veterans

Max Cleland, decorated Vietnam war hero, triple amputee, head of the Department of Veterans Affairs under President Carter, and PTSD sufferer, who came to that knowledge in later life, decades after his military service, has written a new book, called Heart of a Patriot: How I Found the Courage to Survive Vietnam, Walter Reed and Karl Rove.

There was an interview with Cleland on NPR's Morning Edition yesterday, October 6, 2009, linked here.

But most interesting for our purposes -- since this blog is about combat veterans and PTSD -- is the "open letter" to other veterans that Cleland writes, and which is excerpted as part of the NPR piece.

"As combat veterans," he writes, "we have been through some of the most traumatic life experiences possible. War is as close to hell on earth as anything ever could be. That does make us different from our loved ones back home. War marks us all, some more deeply than others."

There's some wonderful, heart-felt expression in this letter:

"The soldier's lot is to be exposed to traumatic, life-threatening events — happenings that take us to places no bodies, minds, or souls should ever visit. It is a journey to the dark places of life — terror, fear, pain, death, wounding, loss, grief, despair, and hopelessness. We have been traumatized physically, mentally, emotionally, and spiritually. Some of us cope with exposure to hell better than others. Some are able to think of their combat experiences as but unpleasant vignettes in a long and wonderful life. It is not to those veterans I am speaking. I love them, but I am not afraid for them.

I am speaking to the rest of my brothers and sisters, those who find themselves trapped in the misery of memories as I was for so long. For them, I am afraid.To those veterans I say, you are not alone.

Many of us have been overwhelmed by war. Many of us have been unable to cope on our own with what has happened to us or with what we have done. Many of us have been left hopeless, lost, and confused about ourselves and our lives in ways we never thought possible.

That does not make us victims. It makes us veterans."

The rest of the open letter is equally wonderful, and well worth reading. In it, Cleland talks about his own personal highs and lows, what he understands about PTSD and his own case, and what has helped him get through. It's clear the concern and caring he feels for other combat vets. The letter is linked here.

"Ding, Ding" -- Pavlov's Comment on PTSD

Famous Russian scientist (physician and psychiatrist) and Nobel Prize winner Ivan Pavlov -- famous for his experiments with ringing bells, feeding time and dogs that evoked the characteristic "Pavlovian response" -- also had some things to say about PTSD.  Bessel van der Kolk, M.D., a Harvard-trained psychiatrist, writing in his scientific paper, "The Body Keeps the Score: Memory and the Evolving Psychobiology of Post Traumatic Stress," mentions that Pavlov thought that "individual differences in temperament account for the diversity of long-term adaptations to trauma."  Interesting!

Editor's Note: The item van der Kolk appears to be citing is Pavlov IP.  Edited and translated by GV Anrep.  "Conditioned reflexes: An investigation of the physiological activity of the cerebral cortex."  New York: Dover Publications (1926).

Helping Vets with PTSD: Rolling up Your Sleeves vs. Keeping an Arm's Length Distance

We've talked before on this blog about Paul Tillich's fabulous quote, that "the first duty of love is to listen." 

Here's a story that neatly conveys the polar opposite of that; or at least how someone, a VA provider, got actually PUNISHED for doing that (thanks to Ilona Meagher for noticing the story). But first, an aside.

I was at a dinner a while back that concluded a week's worth of focused training for health care providers, mostly psychologists, psychiatrists and social workers -- many of whom dealt with combat veterans.  Seated across the table from me was a VA provider, a Ph.D. psychologist who, to his credit, was of the Vietnam era but hadn't served, and who had gone into working with the VA so that he could "help" his generation of veterans, who he saw as being tremendously underserved.  True and good, so far.

As we sat at dinner, he told the private practice psychiatrist to one side of him, and the veterans service officer (and Iraq War combat vet/single mom) to the other side of him, about something "new" called "EMDR," that neither one had ever heard of, and that he had just learned about, and  was fairly enthusiastic about himself.  EMDR, for "Eye Movement Desensitization and Reprocessing," for one thing, is NOT new.  It's been in existence for years -- since the 80s, when it was developed by Francine Shapiro, Ph.D..  Something like 16 clinical trials have shown its efficacy. Heck, we've got several blog posts about it, from two years ago. So it's not really great news that the provider was "just learning about it" recently.  EMDR was one of the first quasi-"alternative" treatments offered in the psychological community for PTSD.  It's been widely studied and fairly widely recommended for PTSD ever since.  It's also something I've personally tried, so my ears perked up when I heard it.  "This stuff is so great," the VA psychologist enthused, warming to his true point: "You can treat people, and you don't even have to hear their stuff!"

Ohmigoodness.  If that isn't just the gold standard of what we want to be doing.  I'm holding out hope we'll find an arm's' length cure for healing combat trauma (kidding, absurd).

In this article, a VA provider who seems like a serious, intense, and concerned practitioner -- as well as a favorite among the veterans who were her patients -- gets fired and reprimanded for "talking an Iraqi vet down off the ledge," so to speak.  It's a pretty shocking story.  The provider has yet to be re-instated, and the OIF/OEF veteran who narrowly survived killing himself, thanks to her intervention, also has been left scarred by the situation, and more antisocial/less trusting than before.  Ugh.  Is this the kind of care we really want to be delivering?

The VA, particularly now (as in, these days) is supposed to be "very concerned" about its reputation, and really adamant about "no more bad PR."  If that's the case, maybe it's time to examine some of the decisions that get made, and why they get made -- from what happened in this story, to the psychologist above who was so thrilled to learn about a treatment mode that he could practice without having to get too involved.

Somehow, this seems to be the EXACT OPPOSITE of the care and concern and COMPASSION that someone like Sarah Haley exhibited, herself a VA psychiatrist, through whose landmark work the shame of My Lai was able to come forth and be addressed, etc. A true hero in the pantheon of those who addressed PTSD at its roots -- and, coincidentally, ALSO someone very well loved by her patients.  Hmmmn.  There might be a not-so-subliminal message in that. 

Here's what Gerald Nicosia, author of Home to War: A History of the Vietnam Veterans' Movement, says in part about Haley (to whom he devotes more than a dozen pages of narrative):

"The other horn of this troubling dilemma was that the traumatized person, especially if he was a Vietnam veteran, would almost never come in and spill his guts to a perfect stranger.  Trauma patients need to establish trust with a therapist, and the Vietnam veterans coming into the VA clinic were never being given the chance to do this.  It was by the merest lucky chance that the My Lai veteran had seen something in Sarah Haley that made him believe he could confide in her, thereby opening the door not only to his own dark secrets, but also to possible help for a whole generation of trauma victims."

 

And, separately:

 

"What Haley did not realize was that John [the aforementioned patient, who spilled the beans on My Lai] had come to her initially because he had been told she was trustworthy by his friend Mike, whom she had treated previously.  A year later, John showed up in her office again under the pretext of bringing Mike back for further counseling.  At this time, John confessed to her that "he had needed to believe that just one person cared, that one person could be trusted to know what he had done, and not reject him.""

 

Hmmmn.  Food for thought, all the way around: but most especially for the VA, and their apparently quite shabby treatment of psychologist Sidney Ornduff, and by extension, the other veterans whose lives she could have been helping.

 

PTSD in Antiquity -- the Apostle Paul

Those of us who've spent more time than we care to admit it around religi-anity are familiar with the story of the Apostle Paul.  Probably a Hellenic Jew, he had a strong background persecuting -- i.e., killing -- Christians -- which all the more shocked first century Christians when he converted and became one.  Christian churches often use the story of Paul, an aggressive non-believer, as an example of how "anyone can become a Christian," even one fervently opposed to Christians and their teaching, such as he was in his early years.

As he says about himself, in Acts 22: "⁴I persecuted the followers of this Way to their death, arresting both men and women and throwing them into prison..." And later in the same passage, "'Lord,' I replied, 'these men know that I went from one synagogue to another to imprison and beat those who believe in you. ²⁰And when the blood of your martyr Stephen was shed, I stood there giving my approval and guarding the clothes of those who were killing him.' "

For our purposes here, though, there's something more interesting about the Paul story.  How the frustrations he espouses in his later life are really textbook PTSD hallmarks: from killing Christians. 

¹⁵I do not understand what I do. For what I want to do I do not do, but what I hate I do. ¹⁶And if I do what I do not want to do, I agree that the law is good. ¹⁷As it is, it is no longer I myself who do it, but it is sin living in me. ¹⁸I know that nothing good lives in me, that is, in my sinful nature. For I have the desire to do what is good, but I cannot carry it out. ¹⁹For what I do is not the good I want to do; no, the evil I do not want to do—this I keep on doing. ²⁰"

(The foregoing passages are from Romans 7.) Paul pitches this as a battle between good and evil,   between sin and God; but we can just as easily see this as the characteristics of PTSD that Paul could not shake, even though he had left his former life as a killer of Christians, and reconciled himself to God.

How many combat veterans with PTSD sit in the wreckage of ruined family celebrations, and wonder the same things? To have the intention to experience one thing with their loved ones, but end up being blindsided by feelings and reactions they can't control? And who end up feeling terribly ashamed for how things turned out, when they really meant for them to be so very different?

Many veterans with PTSD "solve" this dilemma by "taking themselves out of the mix," either figuratively or literally, by sequestering themselves "off in their bunkers" away from family and friends, mainly out of a desire to protect their loved ones from one more disaster at their hands, and to avoid the all-too-familiar triggers.  Unfortunately, quality of life is lost somewhere along the way, and trigger-avoidance only goes to behavior control, not finally lessening the symptoms or reducing the overall sum of what's there to be triggered.

Seems that current suffering veterans, with or without specifically religious leanings, may have an antecedent of their own in none other than the Apostle Paul.

---

Editor's note: More than a hat tip to Pat, whose insight this really was...

"I Had My Hard Lessons in Life" - Ambrose Bierce, Literary Poster Boy for TBI and PTSD

It's getting hard for me to think of Ambrose Bierce as anything but the quintessential, though unrealized, poster boy for PTSD (and secondarily, TBI) from the Civil War era -- in addition to his stature as a journalist and writer of quite macabre short stories...and the funny-as-hell classic, "The Devil's Dictionary."  

(The painting pictured, too, shows Bierce with the human skull he allegedly kept on his writing desk "for inspiration".)

The more I read about Bierce, the more his symptoms jump off the page -- really consistent, too, with the extreme amounts of combat trauma he experienced.

More on that later, as it comes up, but here's an item from an unrelated book I've just been reading, which mentions Bierce's "mentorship" of another San Francisco-based writer, George Sterling.

"This was Sterling's first lesson.  Many more followed.  Bierce...obliged him to visit the city morgue, where he bribed an attendant to display bodies for them to "strengthen the spirit."  When Sterling had to rush from the place and vomit in the gutter after viewing the corpose of a drowned man, Bierce said, "Don't be embarrassed...When I was eighteen, I had to go out and bury soldiers and horses who had been lying in the sun for a week.  I had my hard lessons in life, too."

---

That passage is followed by another in the same book, where a different San Francisco writer -- Jack London -- reinterprets Bierce's fixation with death to the same young writer, George Sterling:

"They walked up Grant Avenue and Sterling told London about the evening that Bierce had dragged him around the city, ending up at the morgue.

"That figures," London snorted.  "Bierce is fascinated with death because he detests life.  He's afraid of it, I think.  He doesn't want to live in the real world. Anyway, I'm not taking you to any damned morgues tonight.."

-- Source: Realms of Gold: The Colorful Writers of San Francisco, 1850-1950, by George Rathmell.

Another intepretation of course is that perhaps Bierce had seen "too much" of the real world... and was still trying to put the pieces together, for himself, even decades later.

Teddy Roosevelt on Veterans - Give 'Em a Square Deal, Afterwards, for Serving

A quotable quote from the 26th president of the United States, who served as a legendary Rough Rider during the Spanish-American War, and also as an Assistant Secretary of the Navy:

"A man who is good enough to shed his blood for his country is good enough to be given a square deal afterwards. More than that no man is entitled to, and less than that no man shall have."

The Danger of Incomplete Mourning: "Unable to Achieve the Catharsis of Grief"

Deep within the William Styron memoir, "Darkness Visible," which we blogged about recently, here, is this observation of his about what might have precipitated his own depression.  Because it touches on things we've covered over and over again on this blog, it seemed very worth mentioning -- as well as quite profound:

The morbid condition proceeded, I have come to believe, from my beginning years – from my father, who battled the gorgon for much of his lifetime, and had been hospitalized in my boyhood after a depression spiraling downward that in retrospect I saw greatly resembled mine.  The genetic roots of depression seem now to be beyond controversy.  But I’m persuaded that an even more significant factor was the death of my mother when I was thirteen; this disorder and early sorrow – the death or disappearance of a parent, especially a mother, before or during puberty – appears repeatedly in the literature on depression as a trauma sometimes likely to create nearly irreparable emotional havoc. 

 

The danger is especially apparent if the young person is affected by what has been termed “incomplete mourning” – has, in effect, been unable to achieve the catharsis of grief, and so carries within himself in later years an insufferable burden of which rage and guilt, and not only damned-up sorrow, are a part, and become the potential seeds of self-destruction.

From Darkness Visible: A Memoir of Madness, by William Styron.

One Author (and Former Marine's) Attempt to Make "Darkness Visible"

I read the classic Darkness Visible: A Memoir of Madness, by William Styron, the other night.  It's a quick but melancholy read and takes about an hour. (What I didn't realize at the time -- and it's completely tangential to his story, which is really about a four year bout the well-known author had with clinical depression, and the closeness he felt to suicide -- is that Styron was a former Marine.)  Styron died of pneumonia in 2006, at 81 years old.

In an obituary printed about Styron on Martha's Vineyard where he had a home, the following information about his military service is revealed:

Following high school [Styron] joined the reserve officer training program for the United States Marine Corps, and enrolled at Davidson College. He was unhappy there and through the Marines transferred to Duke University in June of 1943. In October of 1944 he was called to active duty and in late July 1945 was commissioned a second lieutenant. He was assigned to participate in the invasion of Japan; a month later the atomic bomb attacks forced the surrender of Japan and he was discharged. ... In 1955 he published The Long March, originally a novella about his experiences in the U.S. Marine Corps.

The same obituary also makes clear the trajectory that led to Styron's depression, and the resultant book that introduced this highly personal experience of the author's to the American public:

[Styron] drank heavily and smoked cigars until the summer of his 60th birthday in 1985, when he decided that alcohol no longer agreed with him and gave it up. But the abstinence triggered mood disorders which required medication, and the drugs in turn brought on a deep, enduring and suicidal depression that required him to be hospitalized for more than two months. The experience prompted him to write Darkness Visible: a Memoir of Madness, after he had recovered.

The book earned Mr. Styron a whole new set of followers. "I think it causes people to realize two things," he told the Gazette in an interview in 2001. "That this is a pain that afflicts a lot of people; it's universal and if I could describe it in this way and people could relate to it, it meant they weren't alone; and the second thing - almost as important or more important - is stressing the truth that people can get well, and that it's not by any means fatal."

Styron's book is interesting, to a degree, mostly because of his prominence as an author at the time he wrote it, and because it is so uniquely personal: One person telling the story of his own descent into "madness." I wasn't a complete fan: it's a little hard to keep reading how marvelous Styron's life was, yet how unhappy he was within it -- true though that might be.  And the entire book, while short, is one continuous slog through the same miserable territory, until his case finally improves towards the end (mostly thanks to hospitalization, it would seem.)

However, there are some interesting parts.  One is near the beginning, where he quotes the French writer Albert Camus, "There is but one truly serious philosophical problem, and that is suicide."  In Styron's hands, the problem becomes more physiological than philosophical.  He tries to put off suicide, while coping with his depression -- but first, cataloging his depression fairly exhaustively for the reader (or himself, it's never too clear.)  He covers some standard themes, such as how self-medication with alcohol kept his demons at bay for years, until he cold turkey gave up drinking, and watched his depression take on form and substance.  He explains how the common response of depression is to be more interested in injuring self than others (small comfort, that).  And he mentions the unique aspect we discuss here from time to time, about how psychological pain can manifest as, or at least be accompanied by, physical pain.  In Styron's words, about his own case:

"What I had begun to discover is that, mysteriously and in ways that are totally remote from normal experience, the gray drizzle of horror induced by depression takes on the quality of physical pain.  But it is not an immediately identifiable pain, like that of a broken limb.  It may be more accurate to say that despair, owing to some evil trick played upon the sick brain by the inhabiting psyche, comes to resemble the diabolical discomfort of being imprisoned in a fiercely overheated room.  And because no breeze stirs this cauldron, because there is no escape from this smothering confinement, it is entirely natural that the victim begins to think ceaselessly of oblivion." 

(Hmmmn.)

Styron indulges in one of the book's only tiny moments of humor when he describes the loss of his libido, which he says happened pretty much as soon as the depression settled in.  Describing a conversation with a doctor he felt 'just didn't get it,' Styron writes:

"...I wondered if he seriously thought that this juiceless and ravaged semi-invalid with the shuffle and the ancient wheeze woke up each morning from his [sleeping pill-induced] sleep eager for carnal fun."

Styron helpfully delineates his personal symptoms and by so doing, provides an example for others about what depression can look and feel like.  He describes his sensations of pain, his loss of libido, his weakness, his weak and distant voice that made him sound much older than his years, etc.

He also describes his troubling experience with several doctors (he calls them "careless") who overprescribed medications to him, including sleeping pills, at levels that were dangerous and could have provoked suicidal thoughts. It's unclear whether Styron ever considering a malpractice lawsuit against these doctors, but what he describes doesn't sound good -- and it sounds like he just took it in stride and was thankful he wasn't harmed, but didn't pursue any further action.  Ironically, eventually it's medication that helps him get well, once he is hospitalized.  Before he commits himself, however, he reaches the end of his rope and contemplates suicide.  When he finally realizes how sick he is, he heads for the hospital, and, there removed from other distractions, is able to (in his opinion) concentrate on his cure.From other things I've read since, it sounds like Styron continued to battle depression off and on for the rest of his life, and probably had struggled with it for many years beforehand, also.  At no point in the book is there any indication about his military service having an effect, pro or con, on his depression.  In fact, it sounds like his depression was both genetic and environmental -- but had nothing to do with being a Marine.

By page 84, the last page of the short book, there is finally a ray of at least faint light.  Styron is getting better, and he sums up -- neatly mentioning Dante, the subject of a previous post here on this blog:

For those who have dwelt in depression's dark wood, and known its inexplicable agony, their return from the abyss is not unlike the ascent of the poet [Dante], trudging upward an upward out of hell's black depths and at last emerging into what he saw as "the shining world."  There, whoever has been restored to health has almost always been restored to the capacity for serenity and joy, and this may be indemnity enough for having endured the despair beyond despair."

And then he concludes with a quote from Dante, mirroring the optimism that is finally able to see in his own situation:

"E quindi uscimmo a riveder le stelle.

And so we came forth, and once again beheld the stars."

Editor's note: If you want to read more about Styron's later work, referencing this book as well, there's a good article from 2003 in the Guardian, linked here.

Sarah Haley - Psychiatric Social Worker, PTSD Pioneer, Friend of Veterans

Gerald Nicosia's book Home to War: A History of the Vietnam Veterans' Movement, is fascinating reading, if only to keep in mind the wisdom of the George Santayana quote, "If we do not learn from the mistakes of history, we are doomed to repeat them."  Nicosia goes into much detail about how the PTSD diagnosis was first determined and included into the DSM, and along the way he paints the picture of many of the key participants, including Sarah Haley, in first treating Vietnam veterans for combat trauma and the resultant PTSD.

Whenever we look at history like this, it becomes apparent that whoever is impressive today in this work owes so much to pioneers like Haley (who Nicosia discusses) and Lawrence Kolb, M.D. (who Nicosia oddly does not).  "Standing on the shoulders of giants" is the semi-cliched expression about what present practitioners owe as a debt to the pioneers of the past, and it is certainly true about Haley's work: she was a true giant.

Here I'm going to excerpt, with Nicosia's permission, parts of the many passages about her work so you can see three important things: what her background was, which gave her a special compassion for the truth the veterans first presented with; the extent of her rapport with and trust established with the veterans themselves, which allowed her to help them; and some of her more intuitive leaps about what PTSD really meant from the lives of veterans with whom she consulted.  What a truly remarkable person; and what a shame she's no longer with us, so that we can continue to benefit from her truly outstanding work with veterans.  (Few of these quotes are continuous; most skip around from important part to important part, with the gap indicated by the ellipses)

Haley's background:

"It was a woman .. a psychiatric social worker named Sarah Haley, in the big VA outpatient clinic in Boston, whose research into veterans’ stress disorder literally blew the existing psychiatric definitions to pieces and began to put a whole new definition on the map.

"Sarah Haley [initially] seemed the least likely person in the world to make waves…

Her friends all warned her that the VA’s psychiatry program was “fifth-rate,” that she would find herself treating ‘chronic schizophrenia and passive-dependent men with bleeding ulcers,’ and that her career would surely go down the tubes.  But despite the fact that she entered upon her new VA job with the meagerest of expectations, she couldn’t help being ‘shocked at the low caliber of the general run-of-the-mill health person there.’  As she recalls, ‘These were not mental health people that you would want anybody in your family to get near.’"

 

Haley's first astounding discoveries:

"One day, a young man in a highly agitated state was brought into the clinic by his parents.  He had only been home from Vietnam for three days, and his parents had no idea what to do with him.  He was having total body tremors and exhibiting ‘startle response’ every few minutes.  If a car backfired or a door slammed, he would dive under the nearest table.  After much rambling, the young man told her he had been at a place called My Lai, that terrible things had happened there, but that it was difficult to piece it together.  He was confused and experiencing a lot of amnesia, but he did remember seeing the bodies of women and children and vomiting into the bushes.  He also remembered that he could not shoot anybody himself, that he had thrown his gun down.  The American soldiers who did the killing had sought to intimated him and the others who didn’t shoot: ‘If you ever tell anybody, we’ll come get you.  Or we may come get you anyway.’

 

…

"Indeed, any other intake worker might have dismissed [this recent Vietnam veteran] as delusional, but Haley had reason to believe him.

(Her father had been on special operations with the OSS in North Africa during World War II, a self-admitted ‘assassin for the government.’  He had told her about seeing a truckload of German prisoners who were led out and made to kneel in front of a ditch, where an American officer shot each one of them methodically in the back of the head.  Then the Americans dumped their bodies in the ditch and shoveled it over.  Thus Haley, as she puts it, had “no illusions about war.”)

 

How Haley worked with veterans and understood their particular trauma:

"Haley had nothing to go on but a big hunch, but she decided to follow it.  It seemed to hear that a lot of mental health professionals – especially those at the Boston VA clinic – had great difficulty in listening to the recital of trauma: as a defense, they either disbelieved it off the bat, turning it into the less threatening notion of “delusion,” or else withdrew from the patient as quickly as possible so as not to have to hear more about it. 

 

The other horn of this troubling dilemma was that the traumatized person, especially if he was a Vietnam veteran, would almost never come in and spill his guts to a perfect stranger.  Trauma patients need to establish trust with a therapist, and the Vietnam veterans coming into the VA clinic were never being given the chance to do this.  It was by the merest lucky chance that the My Lai veteran had seen something in Sarah Haley that made him believe he could confide in her, thereby opening the door not only to his own dark secrets, but also to possible help for a whole generation of trauma victims.

Haley perceived correctly that the reason the My Lai vet could not remember all the details of his trauma was that much of the most painful material had been repressed.  In the coming years, she would encounter the same phenomenon in hundreds of Vietnam veterans, some of whom could only recall five or six months of their 12- or 13-month tours of duty.

 

More insights into how Haley worked with veterans, and uniquely modified the approach for dealing with combat trauma:

"She further realized that the stuff was eating away at them would have to be brought slowly and steadily to the surface – that there were no quick fixes, like ‘5 mg. Stelazine daily.’  Equally ineffective, she would soon discover, was ‘the sort of non-authentic treatment’ where the professional would talk about family issues or other daily matters that were troubling the patient, but never bother asking about the existence of trauma in his past; for if the professional didn’t ask, the trauma victim would seldom bring it up on his own. Haley was aghast to learn, for example, that an analyst friend of hers had “successfully” treated a Vietnam veteran solely on the basis of working through the rivalry with his father and never even asked the veteran about his [combat experience.]

"Most of the Vietnam veterans Haley found were coming in to see a VA psychiatrist merely so that they could get their next month’s supply of Valium.  Haley would go to the psychiatrists and inquire whether they had ever asked these veterans about their Vietnam experience; the usual reply from the shrinks was that they had stopped asking because the veterans didn’t want to talk about it.  Haley was flabbergasted that none of the VA psychiatrists – with the exception of two notable women, Lillian Rodriguez and Constance Hartwell – evinced any interest in learning the cause of the tremendous anxiety for which they were blithely prescribing shelves of medication.

Unique problems to Vietnam veterans that Haley noted:

"During those first few years at the VA, Haley encountered a great many vets who talked about participation in atrocities.  she found most of them to be ‘terribly guilty, feeling unclean, and not worthy to be back in the world.’

…

 

"… Instead of hearing, “Doc, I have a bellyache,’ or “Doc, I’m seeing visions,” or “Doc, I’m terribly depressed,” what Haley would hear time after time was, “Doc, I think I’m a murderer… I slaughtered innocent civilians.”

 

And finally, Haley's substantial impact:

"Working with these men and the material they brought up was so painful that it took Haley almost two years to complete her article…which was immediately recognized as a landmark work.  By precise delineation of the symptoms of several veterans she had treated, Haley established that the Vietnam veteran who had witnessed or taken part in atrocities could not be handled merely as a traditional case of traumatic war neurosis, but presented a completely new challenge to psychotherapy."

Sarah Haley was indeed a remarkable woman, and a great Friend to Veterans.  So much of the unique and compassionate approach to understanding PTSD's impact on veterans comes directly from this woman's work, and for that we are deeply appreciative and honor her in memoriam.

Venturing into the Mental and Spiritual Wreckage of War ... in an Attempt to Patch up the Survivors

I've been enjoying reading Gerald Nicosia's exhaustive chronicle, Home to War: A History of the Vietnam Veterans' Movement, which we blogged about earlier, here.  It's hard to read it without appreciating both the tendency of history to repeat itself (even this recently, from Vietnam to now); and also the quality of the few greats who really stood out for doing important work in bringing the PTSD diagnosis into the modern era.  One such great was Robert Jay Lifton, M.D., a psychiatrist, Yale professor, and author of Home from the War: Learning from Vietnam Veterans, about whom Nicosia makes this wonderful remark:

"It was to Lipton's credit that he took the step no one had yet ventured, wading hip deep into the mental and spiritual wreckage of the war to begin a systematic effort to patch up the survivors."

It's significant that at the time, no one had yet "ventured" that -- one wonders whether today much on that front has really changed.  There are a few, maybe, but the "mental and spiritual wreckage" continues both to abound, and to devastate the survivors.

An Unprecedented Aesthetic Triumph: A War Poet (Jarrell) on a Combat Journalist (Pyle)

Randall Jarrell is famous to many (okay, I'll say it, so you won't have to) ex-English literature majors, and other fans of poetry, including war poetry.  His poem, "The Death of the Ball Turret Gunner," is one of the more famous war poems around.  What I didn't realize until I read more about Ernie Pyle was that Randall Jarrell made one of the more profound quotes about why Ernie Pyle's contribution as a journalist in wartime was so important.  He wrote:

"We felt most the moral qualities of [Ernie Pyle's] work and life; but we could not help realizing that his work was, in our time, an unprecedented aesthetic triumph: because of it most of the people of a country felt, in the fullest moral and emotional sense, something that had never happened to them, that they could never have imagined without it -- a war."

Never read Jarrell's famous poem?  Here's your chance, then: It's pretty short and to the point in its ability to communicate, elliptically, the experience of war on the individual:

 

From my mother's sleep I fell into the State,
And I hunched in its belly till my wet fur froze.
Six miles from earth, loosed from the dream of life,
I woke to black flak and the nightmare fighters.
When I died they washed me out of the turret with a hose.

The two men -- one a poet, who had served briefly in the military, the other a journalist who had embedded at length with the troops, and considered himself one of them -- both served to "amplify" the experience of serving in combat for those to those who stayed at home.  Interestingly, for our purposes on this blog, no one is clear whether Jarrell's "accidental" death at 51 (he was hit by a car while walking) was actually accidental, or in fact a successful suicide attempt.  He had struggled with mental illness (depression) before his untimely death. 

As for Pyle, he died in combat, with the troops he loved and whose individual experience he communicated so successfully to the folks at home.  According to Pyle's obituary in the New York Times, Eleanor Roosevelt herself wrote of Pyle, "I have read everything he has sent from overseas," and, the obituary states, "recommended his writings to all Americans."

---

Just because I can't get enough lately of this journalist with the compassion for those he encountered in combat, I have to add one more quote from his (excellent) obituary.  How I wish we had someone like this today.  See how very much his point of view is needed among veterans today:

Said General Mark W. Clark, from Fifteenth Army General HQ in Europe:

 

"A great soldier correspondent is dead, perhaps the greatest of this war. I refer to Ernie Pyle, who marched with my troops through Italy, took their part and championed their cause both here and at home.

 

"His reporting was always constructive. He was "Ernie" to privates and generals alike. He spoke the GI's language and made it a part of the everlasting lore of our country. He was a humble man and in his humility lay his greatness.

 

"He will be missed by all of us fighting with the Fifteenth Army Group. There could have been only one Ernie Pyle. May God bless his memory. He helped our soldiers to victory."

The Journalist as Witness to "The Powerful Fraternalism of the Ghastly Brotherhood of War"

 

I knew a trial lawyer once who had won hundreds of cases in his time, and who had -- as anyone does who primarily makes his living talking -- a few really memorable quotes, culled from various places over the years, and very useful for making certain points to juries and his peers.  Here's the best one I remember of those, which I've had opportunity to use myself over the years since.  It's allegedly from the American jurist Oliver Wendell Holmes, and it basically says, "Even a dog knows the difference between being kicked, and being tripped over."  All too true.  And all the persuasion in the world isn't gonna convince you otherwise -- if you're the dog, that is.

The world at large may always be able to debate, fairly inconclusively, whether a journalist is, or even should be, a thoroughly impartial observer to others' suffering - and what changes if and when the journalist becomes part of the story.  That indisputably great humanitarian of our time, Oprah Winfrey, started as a broadcast journalist, but had to give it up when she realized she was more interested in holding a victim's hand and comforting them than, say, aggressively interviewing them for the "story."  It makes sense, given what she was able to morph into being, that she would have had her misgivings about being there "just for the story."  Journalists like Daniel Pearl (sadly), and Zoriah (lately) can inadvertently become the subject of a story themselves, when circumstances present themselves or change so that they become the focus of the news, instead of reporting on the news.  Fundamentally, though, journalists are witnesses -- witnesses to history, of which they are often writing the alleged "first drafts" -- given that they're on the scene at the time.

Now here's someone interesting who basically confirms the paradigm of the journalist as witness/observer, but explodes the myth of being the impartial onlooker: Ernie Pyle.  Ernie Pyle is known as the greatest war correspondent who ever lived, and the reality is, he earned that accolade for many reasons.  But perhaps the biggest was this: he took a genuine interest in his subjects who -- like the celebrated dog in the quote above -- certainly knew the difference.

In the introduction to Ernie's War: The Best of Ernie Pyle's World War II Dispatches, David Nichols writes:

"Ernie Pyle covered World War II the way the infantry soldier fought it: on the ground and on the move, subject to fear, filth and the capricious fates that dealt death to one man, life to another.  Pyle was a novelty as a war correspondent.  Only rarely did he write about the so-called 'big picture.' Rather, Pyle focused on the individual combatant -- how he lived, endured by turns battle and boredom, and sometimes how he died, far from home in a war whose origins he only vaguely understood."

Ahhh, I think I'm in love with him already...

Studs Terkel, who, along with David McCullough, is one of America's foremost oral historians, writes this about Pyle's ability to touch "millions of readers" with his dispatches, from the same book:

"It is an exquisite irony that this journalist became celebrated for celebrating the non-celebrated.  It is further irony that his deeply moving pieces became dis-remembered at war's end.  So did the war, for that matter.  We may be the richest country in material things and possibly the poorest in memory."

But, he continued:

"Ernie Pyle was painfully aware of this.  In writing of the footsloggers, the grunts, Bill Mauldin's Willie and Joe, he let us know it: "All the war of the world has seemed to be borne by the few thousand front-line soldiers here, destined merely by chance to suffer and die for the rest of us."  He sensed immediately what [war poet] Wilfred Owen, who died in some other war, called Chance's strange arithmetic.  [Editor's note: In an resonance across the generations, some of the Recon Marines in Evan Wright's Generation Kill discuss a similar phenomenon that they call 'the sacred geometry of chance.']

"He knew, too, that it was neither God nor Flag nor Mother that impelled a pimply faced kid to risk, to lose his life in an obscene adventure.  He did it for the kid next to him; he couldn't let him down.  They needed one another so bad.  'I lay there in the darkness ... thinking of the millions far away at home who must remain forever unaware of the powerful fraternalism in the ghastly brotherhood of war'.

"When they found Ernie's body on Ie [an island in the Okinanawan chain, where the battle was being fought], they came across a rough draft of a column [that he had with him.]  Fragments: 'Dead men in such familiar promiscuity that they become monotonous.  Dead men in such monstrous infinity that you come almost to hate them.  These are the things that you at home need not even try to understand.  To you at home they are columns of figures."

When Ernie Pyle died in combat, the whole country reached out to offer their condolences:

President Harry Truman said,

"No man in this war has so well told the story of the American fighting man as American fighting men wanted it told. He deserves the gratitude of all his countrymen."

Secretary of the Navy James Forrestal said,

"With deep regret, the Navy announces the death on Ie Shima (Island) of Ernie Pyle, whose reporting of this war endeared him to the men of the armed forces throughout the world and to their families at home.

"He was killed instantly by Japanese machine-gun fire while standing beside the regimental commanding officer of Headquarters Troop, Seventy-seventh Division, United States Army. At the time of his death he was with the foot soldiers, the men for whom he had the greatest admiration.

"Mr. Pyle will live in the hearts of all service men who revered him as a comrade and spokesman. More than anyone else, he helped America to understand the heroism and sacrifices of her fighting men. For that achievement, the nation owes him its unending gratitude."

Army Chief of Staff George C. Marshall said,

"Ernie Pyle belonged to the millions of soldiers he had made his friends. His dispatches reached down into the ranks to draw out the stories of individual soldiers. He did not glorify war, but he did glorify the nobility, the simplicity and heroism of the American fighting man. The Army deeply mourns his death."

And according to an AP report at the time, Gen. Dwight D. Eisenhower said of Pyle, "The GI's in Europe--and that means all of us here--have lost one of our best and most understanding friends."

The Colonel who was with him in the jeep when they were shot at, and Pyle was killed -- who in fact had just met him, yet instantly had fallen under his spell -- was reported to say, with tears in his eyes:

 

"I was so impressed with Pyle's coolness, calmness and his deep interest in enlisted men. They have lost their best friend."

(All the last five comments, starting with President Truman's, are from the New York Times' obituary of Ernie Pyle -- whose exceptional length testifies to the nation's love for him. That obituary is linked here.)

---

Two observations:

One, we'd be hard-pressed to find a journalist today who could fill even a portion of Pyle's shoes, and be thought of - by veterans themselves - as their greatest friend.

And two, it's incredible what a difference one man's empathy for his fellow man, journalist to soldier, meant for communicating what combat veterans were experiencing to those who were safe at home.  I wish we had such a journalist today.  In the thicket of journalists and bloggers filled as it is with surfacey reflections and reflexive back-patting about how wonderful they are, generally without confirming evidence to support that point of view, I really don't see anyone who combat veterans would consider their authentic, genuine friend.  And without a voice like that, I wonder how well their causes and concerns are really being communicated.  Not in a "want list" for legislative action -- that's being done powerfully by groups like the IAVA and VoteVets -- but in simple, human terms: communicating the cost of war by those who are paying it.  I sure miss Ernie Pyle, even though he was long gone before I ever heard of him. 

Don't you?

Ambrose Bierce - Cynic, Soldier, Journalist (and Early TBI / PTSD Sufferer)

You may already know who Ambrose Bierce is -- contemporary of Mark Twain -- American "humorist" -- but with the most dark and biting, bitter humor around.  (So bitter, in fact, that in his later life, he was known as "Bitter Bierce."  He's famous for some short stories, including the inimitable "Incident at Owl Creek Bridge," which occasionally salvages an otherwise-deadly literature anthology for high school and college students, and also the Devil's Dictionary, which is truly just one of a kind, from which come many of the best "definitions" I've ever seen, about the out and out hypocrisy of language and typically revisionist history, written by the victors.  In fact, though they were rivals, the sentiments behind Mark Twain's famous "War Prayer" -- "Oh, dearest God in the heavens, smite down the other side, mainly because they're not US" (I'm paraphrasing) -- fit right in with Bierce.  While literature types make much of Bierce's cynicism -- he's been relegated to the "humor" side of the aisle, in theory, because of it -- the reality is, he was a soldier who saw many battles, and saw some truly horrible things, in the course of his serving in the Civil War.  Things that jump right out of the pages of his writing, and underscore realities from Vietnam -- like the impetus behind fragging -- and the wars in Iraq and Afghanistan -- including what must have been a "traumatic brain injury" or "TBI" -- when he was shot in the head with a musket in one of the battles in which he participated.

If you fast-forward to the 1980s, Bierce's eventual disappearance in Mexico -- he had gone there to fight -- is chronicled in the fictional movie treatment, "Old Gringo," starring the eclectic cast of (erm) Jane Fonda, Jimmy Smits, and Gregory Peck, as Bierce (he's the "Old Gringo" of the title.)  (The movie was based on a novel by Carlos Fuentes, called The Old Gringo.) Ironically, Bierce's decision to go to Mexico and fight in yet another war seems quite reminiscent of combat veterans today, who agitate on the home front for the battle-fueled adrenaline they can't help missing when they're back.  If you haven't taken the opportunity to acquaint yourself with Bierce's dark humor and realistic depictions of war (as a combatant), do yourself that favor.  And in the meantime, I'll leave you with one of the funnier quotes I've seen in a while, courtesy of the one and only Ambrose Bierce -- "War is God's way of teaching Americans geography."

Editor's Note: Thanks to Chris Lombardi for reminding me this week of the singular, terrible beauty of Bierce, and encouraging me to read his devastating battle account -- "What I Saw of Shiloh" -- which concludes with the highly memorable line about the life that he "should have thrown away, at Shiloh."  Yikes.  He gets it.

Floyd "Shad" Meshad, MSW

After earning his Masters degree in Psychiatric Social Work from Florida State University in 1968, Shad went on active duty in 1969 as a Captain in the U.S. Army. In 1970, he served one tour as a Social Work/Psychology Officer for I and II Corps in the Republic of South Vietnam.

Upon his return to the states, Meshad continued his dedication to American veterans by starting the Vietnam Veterans Re-Socialization Unit at the Brentwood, CA VA Hospital in 1971. He spent eight years working with Vietnam veterans and their severe readjustment problems in the Los Angeles area. Shad was one of the pioneers in the study of the disorder known as Post-Traumatic Stress Disorder, or PTSD.

In the past 27 years, Shad has received many service awards and recognitions for his work. He authored a book about his year in Vietnam, Captain for Dark Mornings, which, highly acclaimed, is in its second printing. Meshad has made appearances on many major television networks and cable news talk shows, including 60 Minutes, 20/20, Dateline, Nightline, and CNN News. Shad continues to consult, train, and counsel nationally and internationally.

In 1986, Shad started a stress management and consulting service. In the early 90's he began focusing on treating compassion fatigue. This condition is identical to secondary traumatic stress disorder (STSD) and is the equivalent of PTSD. It is the stress resulting from helping or wanting to help a traumatized person. Through his associations, Shad introduced Charles Figley, Ph.D., a long-time friend and colleague to Dr. Roger Callahan who developed Thought Field Therapy. Dr. Callahan approached Meshad with the opportunity to study the effect of TFT therapy on veterans who suffered from PTSD. Impressed by the amazing results of this study, Shad has become a certified TFT diagnostician and practitioner, offering seminars on Levels I and II TFT nationwide.

In 2000 Shad founded Quantum Performance Institute with the goal of utilizing the amazing power of energy psychology techniques in the area of negative emotional states and attaining one's optimum performance level.

(More information follows, from a separate bio)

For more than 30 years, National Veterans Foundation (NVF) Founder and President Shad Meshad has worked as a therapist for veterans and an advocate for veterans’ rights. After receiving his master’s degree in psychiatric social work from Florida State University, he enlisted in the army in 1970, and served as a counselor for U.S. soldiers in Vietnam.

Upon his return to the U.S., Meshad founded and directed the Vietnam Veterans Re-Socialization Unit at the VA Hospital in Los Angeles, California. It was the first program of its kind, focusing on the readjustment problems of Vietnam veterans. During this time, Meshad was among the first to study the disorder now known as Post-Traumatic Stress Disorder, or PTSD.

In 1978, he worked to develop and lobby for the National Vietnam Veterans Readjustment Bill. In 1979, he founded the Vet Center Outreach Program, which now serves veterans in more than 200 locations across the country.

In 1980, Meshad was nominated for the first Olin Teague Medal of Service Award. In 1982, he published a memoir of his experiences in Vietnam, entitled “Captain for Dark Mornings.” In 1985, he founded the Vietnam Veterans Aid Foundation, which he later renamed the National Veterans Foundation.

He has served on the faculty of the International Critical Incident Foundation; as President and Board Member of the Association of Traumatic Stress Specialists; and, recently, was appointed to the Board of Directors of the Green Cross Project.

In the wake of the catastrophic events of September 11, 2001, Meshad was called upon by the U.S. government to help train the critical incident and trauma teams at Ground Zero.

Today, Meshad consults and teaches stress reduction and anger management techniques to mental health, law enforcement, and critical incident professionals through Quantum Performance Institute, a firm he established in 2001. He continues his work with veterans in the Los Angeles area, helping them through the process of healing and readjustment.

One Great Book: "Home to War - A History of the Vietnam Veterans Movement," by Gerald Nicosia

"The Past Does Not Equal the Future" -- queue Tony Robbins -- well, unless we refuse to learn the copious lessons of the past, in which case it very well might -- or it might make the past look positively enlightened, by comparison.  Another take on the same thing, by the perennial, inveterate quotemeister himself, Ben Franklin: "Experience keeps a dear [expensive] school, but fools will learn in no other."  I'm reading the greatest book right now, recommended by another journalist who's interested in veterans issues -- "Home to War: A History of the Vietnam Veterans Movement," by Gerald Nicosia, linked here.  It's 2 lbs., 10 oz., 689 pages, and roughly 136 cubic inches of nowhere-else-to-be-found material on the actual history of what created the Vietnam veterans' movement, which informs the veterans' rights movement of today, including the efforts to destigmatize PTSD, figure out what it was, re-include it in the DSM manual for psychiatrists (where it had been removed), etc.  Just fascinating.  All the players are there -- dozens of politically important types, including John Kerry, Ron Kovic (if you've seen "Born on the Fourth of July," you know who he is) as well as therapeutically important ones -- Shad Meshad, Ray Scurfield, Arthur Blank, M.D., Sarah Haley, etc. 

As a late-model Child of the Sixties, I had completely forgotten how much sheer effort -- blood, sweat and tears -- it took to get certain things passed that we now take for granted: better care at the VA, better provisions in the GI Bill, etc.  I had totally forgotten about the armed protests, the hunger strikes and sit-ins at the VA, etc.  It made me wonder whether leaders of the current veteran rights movements actually KNOW this history, and know how far their predecessors had to go, to secure the rights veterans rely on today -- which still need to keep pace with the times, and haven't.  The book is just plain fascinating, and b/c it's relatively neutrally written (as opposed to written with partisanship), with a steadfast focus on the facts and the key participants -- and because it's based on 600 or so interviews with the actual players, it's both extremely well done (a PBS series in book form, but with more depth!) and should keep my interest for quite a while.  So fascinating to know, or begin to hazily recall, the all-important "backstory" of where we are today.  And the insights on the genesis of understanding PTSD are well worth revisiting, all on their own.  Great book - wish I'd known about it before. As more and more veterans send me (unsolicited, I might add) their life stories, or their experiences with PTSD, I have to say -- this book really puts an awful lot together, behind the scenes, as to why they suffered in silence for so long.  Wonderful effort, and a pleasure to read.

Too bad tomorrow is already "Father's Day," but if you're lacking a gift for a veteran dad, Vietnam era or later, and can find this in stock at a local bookstore, it's a superlative collection of everything that went before, and helps us to understand the issues of the present, through the highly informing prism of the past.

War: Is It Glory, or Hell? A Quote from Someone Who Knew

Just ran across this quote allegedly from Civil War general, William Tecumseh Sherman, famous/infamous, among other things, for his "scorched earth" tactics against the Confederate states.  He is supposed to have said, surveying the troops arrayed before him, "There is many a boy here today who looks on war as all glory, but, boys, it is all hell."  Sounds like someone who knew what he was talking about.

"The Hell Where Youth and Laughter Go" -- Young Veterans Suicide in War Poetry

Troubling as the rash of young veteran suicides is, and we need to be extremely troubled by it as a nation -- troubled enough to fundamentally believe that there's a problem that needs fixing -- and it isn't the veteran, but how he or she is treated as expendable by the same system that sends them to war -- here's a wonderful poem by one of the famous WWI war poets, Siegfried Sassoon, that speaks to the essence of the topic:

"Suicide in the Trenches"

I KNEW a simple soldier boy
Who grinned at life in empty joy,
Slept soundly through the lonesome dark,
And whistled early with the lark.
In winter trenches, cowed and glum,	5
With crumps and lice and lack of rum,
He put a bullet through his brain.
No one spoke of him again.     .    .    .    .
You smug-faced crowds with kindling eye
Who cheer when soldier lads march by,	10
Sneak home and pray you’ll never know
The hell where youth and laughter go.

--Siegfried Sassoon (1886–1967).  from Counter-Attack and Other Poems.  1918.

Editor's Note: For a link to Sassoon's poetry on Amazon, click here.  We will also increasingly be listing the work of war poets in a book sidebar as they're mentioned or discussed (see right hand side of page).   Oh, and P.S. -- no ageism intended or implied.  The suicide of older veterans is also tremendously troubling.  Each life taken is a profound loss to society, whether old or young.

Some Things Never Change: Observations of a Civil War Combat Nurse on Trauma

It was interesting, a few weeks ago, reading Louisa May Alcott's first book, entitled Hospital Sketches, about the assignment she sought [as in, asked for -- volunteered for] as a combat nurse in the Civil War.  The work took her to Washington, D.C., where she bandaged and cared for the wounded, and became ill there herself, with a disease whose treatment, years later, many think brought about her early death.  The book was short and and easy reading, written in a mid-19th century style that is not popular today, but it was easy to understand both her motivations for being there; as well as her observations about the wounded who she treated.  It's interesting how some things never change: the acts of bravery, brothery love and kindness, the heartbreak of not being able to say goodbye to your comrades who die; the survivors' guilt, and so forth.  Potent stuff, then as now.  In Balad, at Landstuhl, Walter Reed, Bethesda, the Mologne House, and VA hospitals around the country, these same scenes are playing out, many years later.  And doctors and nurses are no doubt experiencing a fair amount of combat trauma of their own.

(In an aside, too, we know that combat trauma has existed as long as there's been combat.  A study a few years ago even went back to original medical records from the Civil War era, to prove that combat trauma existed then, though called by other names, making that study a first of its kind.  The term "Post-Traumatic Stress Disorder" has only been around since the 1980s.  The underlying concept, however, is as old as war itself.)

In Alcott's Hospital Sketches, however, the part that stood out the most to me was an item she wrote about a young veteran, clearly suffering from combat trauma.  We'll include that towards the end, here.  First, though, a general observation about her first time seeing the ward of injured veterans:

"There they were! "Our brave boys," as the papers justly called them, for cowards could hardly have been so riddled with shot and shell, so torn and shattered, nor have borne suffering for which we have no name, with an uncomplaining fortitude, which made one glad to cherish each as a brother.  In they came, some on stretchers, some in men's arms, some feebly staggering along propped on rude crutches, and one lay stark and still with covered face, as a comrade gave his name to be recorded before they carried him away to the dead house.  All was hurry and confusion; the hall was full of these wrecks of humanity, for the most exhausted could not reach a bed till duly ticketed and registered; the walls were lined with rows of such as could sit, the floor covered with the more disabled, the steps and doorways filled with helpers and lookers-on; the sound of many feet and voices made that unusually quiet hour as noisy as noon; and, in the midst of it all, the matron's motherly face brought more comfort to many a poor soul, than the cordial draughts she administered, or the cheery words that welcomed all, making of the hospital a home."

"The sight of several stretchers, each with its legless, armless, or desperately wounded occupant, entering my ward, admonished me that I was there to work, not to wonder or weep; so I corked up my feelings, and returned to the path of duty, which was rather "a hard road to travel" just then."

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Here's the item about the young boy suffering from combat trauma:

"The night whose events I have a fancy to record, opened with a comedy, and closed with a great tragedy; for a virtuous and useful life untimely ended is always tragical to those who see not as God sees.  My [nursing] headquarters were beside the bed of a New Jersey boy, crazed by the horrors of that fateful Saturday [in a recent battle].  A slight wound in his knee brought him there; but his mind had suffered more than his body; some string of that delicate machine was over strained, and, for days, he had been reliving in imagination, the scenes he could not forget, till his distress broke out in incoherent ravings, pitiful to hear.  As I sat by him, endeavoring to soothe his poor distracted brain by the constant touch of wet hands over his hot forehead, he lay cheering his comrades on, hurrying them back, then counting them as they fell around him, often clutching my arm, to drag me from the vicinity of a bursting shell, or covering up his head to screen himself from a shower of shot; his face brilliant with fever; his eyes restless; his head never still; every muscle strained and rigid; while an incessant stream of definite shouts, whispered warnings, and broken laments, poured from his lips with that forceful bewilderment which makes such wanderings so hard to overhear.

And another:

"...when the echo of a sob caused us to glance among the beds.  It came from one in the corner -- such a little bed! -- and such a tearful little face looked up at us, as we stopped beside it!  The twelve year old drummer boy was not singing now, but sobbing, with a manly effort all the while to stifle the distressed sounds that would break out.

"What is it, Teddy?" I asked, as he rubbed the tears away, and checked himself in the middle of a great sob to answer plaintively: "I've got a chill, ma'am, but I ain't cryin' for that, 'cause I'm used to it.  I dreamed Kit was here, and when I waked up he wasn't, and I couldn't help it, then."

The boy [had come in] with the rest, and the man who was taken dead from the ambulance was the Kit he mourned.  Well he might; for, when the wounded were brought from Fredericksburg, the child lay in one of the camps thereabout, and this good friend, though sorely hurt himself, would not leave him to the exposure and neglect of such a time and place; but, wrapping him in his own blanket, carried him in his arms to the transport, tended him during the passage, and only yielded up his charge when Death met him at the door of the hospital which promised care and comfort for the boy.  For ten days, Teddy had shivered or burned with fever and ague [chills], pining the while for Kit, and refusing to be comforted, because he had not been able to thank him for the generous protection which, perhaps, had cost the giver's life. The vivid dream had wrung the childish heart with a fresh pang, and when I tried the solace fitted for his years, the remorseful fear that haunted him found vent in a fresh burst of tears, as he looked at the wasted hands I was endeavoring to warm:

"Oh!  If I'd only been as thin when Kit carried me as I am now, maybe he wouldn't have died; but I was heavy, he was hurt worser than we knew, and so it killed him; and I didn't see him, to say good bye."

This thought had troubled him in secret; and my assurances that his friend would probably have died in any event, hardly assuaged the bitterness of his regretful grief."

{Editor's Note: it would be interesting to see if where she served was actually Mologne House.  She describes it as being unbelievably dreary, and the former site of a hotel, and somehow connected to, or on the grounds of, the main military hospital complex in Washington, D.C. Hmmmn.  Trivial pursuit, but interesting nonetheless. Okay, just to me :-)]