In was one of those early spring mornings in north Louisiana, full of sunshine, where the air smelled fresh and new and full of promise. As I walked up the small hill towards the hospital, I enjoyed smelling the slight perfume given off by bright pink and purple azaleas in full bloom.
I was to meet a new patient that day, not knowing that his pain would touch my life with memories of him I can never forget. Everett walked in my office with a barely noticeable limp. His head hung down in a defeated manner, like he had little life to him. He wasn’t able to make any eye contact with me for a long time.
He answered my questions in a soft and polite way as southern men were taught to do with Ma’am at the end of each sentence. I knew that he had served in Vietnam, where he was awarded a Purple Heart.
Upon lifting his pants leg , I saw a huge gauze dressing on his leg, that was weeping blood tinged serum. He had osteitis or inflammation of the bone. I was literally astonished when Everett told me that his injury had never healed, despite multiple surgical interventions and antibiotics in over 28 years!
The addiction unit, where I worked three times a week as a therapist was full of vets from nam or the gulf war struggling with various addictions to alcohol, crack, heroin, cocaine, and even gambling. Some had poly addictions of multiple drugs and alcohol.
Today there are huge welcoming ceremonies for our soldiers coming back from war, hailing them as heroes, but during the Vietnam war that was not the case.
Some of these forgotten heroes from the past, have bitter feelings having watched their much younger comrades from other wars being celebrated upon their return, rather than being submitted to being cursed at, insulted, spit upon and in general denounced as a lot of returning soldiers from Vietnam suffered.
Everett was from a large rural family that was very modest financially but was close-knit with many extended family for support. He was raised by his grandmother primarily, because his mother worked long hours as a domestic for two families to help ends meet.
His grandmother, the light and love of his life had recently died. She was a deeply religious person, whom Everett grew up sharing her beliefs.
When I touched upon his spiritual beliefs, he remained silent for a long time, hanging his head even lower. With much courage he finally raised his head where overwhelming tears from his big brown eyes, had started to stream down his cheek. “Ma,am, I am going to hell”, he replied.
“I have done things God can never forgive,”, he added. Everett wasn’t able to share at that time why he had sentenced himself to such a fiery doom, and I didn’t push.
Patients with PTSD, or Post Traumatic Stress Disorder have deep psychic wounds that if poked and prodded, can tear off that needed scab that would only serve to increase their pain, so therapists must go slowly with much care and patience.
PTSD can occur from any trauma, such as rapes, airplane crashes, car accidents, holocaust, fires, childhood abuse or any other life threatening violent exposure besides war combat situations, but this post will deal only with combat PTSD.
Exposure to combat will leave the 50 to 60% of soldiers to some degree of PTSD, that can vary in the intensity of symptoms and disability. If left untreated, it can fester into total hopelessness and suicide.
PTSD patients can become so emotionally disabled that familial relationship can deteriorate and be torn apart. Children of PTSD patients suffer likewise due to the chronic emotional numbing, which can contribute to generational trauma.
Initially, after any trauma, there is immediate shock and a numbing out occurs as a psychic breaking mechanism and even partial amnesia of the traumatizing event.
Symptoms might not appear till many months or even years later. It is not at all unusual for the majority of symptoms in soldiers to appear when they have to transition back home.
No longer forced to deal with life and death survival on the war field, the demons that have been laying dormant locked up in their psyche can surface with vehemence, long after the welcoming home ceremonies have faded.
For many, that is when their war of sanity begins. Turning to drugs, a lot of times mixed with alcohol, becomes a way of coping with their life, leading to life threatening addictions. Many unable to find work, or even keep jobs due to their mental torture end up on the streets homeless.
Whatever sanity they had, starts to unravel into sleepless nights, sweats, nightmares, flashbacks, hyper vigilance, explosive anger, easily startled, panic, and a deepening despair and depression that slowly weaves a tight prison of hell around them.
Any trauma will leave brian tracings of the event and can impact changes in several areas of the brain, most notably the hippocampus, which has been found in PTSD patients to have a reduced volume. Horrific retrieval of memories can be triggered, called flashbacks, replaying over and over the sounds, visions, fear,and even smells of the violence.
This torment seems unstoppable, except when drugs and alcohol can somewhat dim them by pushing them aside out of center stage, but the fix is never permanent, only temporary.
After awhile, the patient builds up a tolerance to whatever substances he is using, and greater amounts are need to quiet the living hell inside them. Any triggers could reactivate the trauma at any time to the degree that some become temporarily disoriented and think that they are back in combat, fighting the enemy.
These triggers for Vietnam vets were generally sounds that resembled a helicopter, loud booms, burning smells, fire crackers, asian faces, and even summer rain storms that were prevalent in Vietnam during the rainy season. I personally witnessed one vet, who while eating in the hospital cafeteria, had to be coaxed out from under the table screaming that “Charlie is in the bushes”, using the term “Charlie” always designated the enemy.
These psychotic like breaks comes from the reenactment of the trauma that is traced in the brain, activated by any of his precipitating triggers, that could vary from one soldier to another. When it happens, they are unable to differentiate current reality from the reenactment of the trauma, and can be of danger to themselves and others.
An older psychological term for this is an abreaction. Family members seeing a love one go from one minute of sanity to a complete psychotic break in minutes is very frightening to say the least.
Flashbacks can last for several minutes or even longer, and besides the depression and nightmares, is one of the most tormenting experiences to go through, because it intensifies the pain they initially experienced in combat.
Medications are used to eliminate the majority of these symptoms, but breakthrough nightmares and flashbacks can occur. When the patient is more stable, then psychotherapy can become a vital part of the treatment protocol.
Veterans can have a general reluctance of sharing combat trauma with those who have never served in the military, nor seen combat. I think because of my very soft and maternal approach and genuine care for their suffering, I was able to break through that resistance.
Suffering is a universal feeling, that most human beings have gone through at one time or another in their lives, so, so for me it is easy to feel my patients suffering, even though it may not have come from similar circumstances.
War is cruel and inhumane for all, soldiers and civilians. Having to kill the enemy in order to protect oneself and buddies while implementing a strategic battle plan is part and parcel of a soldier’s day.
Being involved or witnessing the savagery of human carnage must be the most traumatic gruesomeness to carry in any normal person’s brain, even more so for sensitive souls. Tragically many innocent civilians, including children are often accidentally killed along with the enemy.
It took a lot of courage for Everett to share his pain with me. Napalm was used during that period to burn ond and destroy the thick Vietnamese jungle bush in order to root out enemy soldiers in hiding.
Everett was a part of a napalming mission in an early dawn raid of an area suspected of harboring Charlie. In a devastating flash of untold horror, Everett realised that a mother with her children, were hiding, not soldiers and witnessed their gruesome death.
Besides the tortuous images that often haunted him, he developed a malignant guilt that eroded down to his very core. In his eyes he was repugnant, and full of damnation, and beyond any possible salvation.
He said he wished he would have been killed instead and in that instant his life was doomed to living out this horror he was never able to share before. Grief, shame and chronic guilt consumed him, that even drugs and alcohol could not dim.
For 28 years, Everett had kept his poisonous feelings to himself with his frozen tears, who only in treatment had permission to flow. Now I knew why his leg injury had never healed.
You can never totally separate psychic pain from being manifested in our bodily tissues. The frozen tears that Everett could never thaw, kept his leg wound open to weep through his ever present gauze bandage.
In addition to daily individual therapy, I arranged for him to see the chaplain several times and after a month he was discharged with new hope and promise, not only for his sobriety, but for his image of himself.
Everett lived too far to attend my weekly outpatient group, but with subsequent followup visits, I was able to bear witness to a new man. Allowing himself to return to church, he had met a woman and was developing a relationship that looking promising.
Not surprising to me, but even more astonishing to him, after a repeat debridement of his leg wound during his hospitalization, it was showing signs of healing in that there was no longer any serum weeping.
There have been thousands more men and women, like Everett who are walking around in silent suffering, bravely trying to mask their pain. As I write, they are being taunted and tortured this very minute.
It was not unusual for soldiers to be deployed multiple times within several years. My daughter who worked in outpatient psych at Landstudl Army Hospital in Germany that received wounded soldiers from Iraq and Afghanistan, met combat weary soldiers, who had been deployed up to seven times!
An average of 22 American veterans commits suicide daily! The number of PTSD and Traumatic Brain Injury diagnosis have increased significantly which has currently clogged the available health facilities of the VA, ever caught up in its bureaucracy and it’s dependency on governmental funding.
Yesterday’s memorial celebrations with all the pomp and ceremony for our returned heroes and the many whose lives were lost is wonderful, but our empathy, concern and compassion is needed for those afflicted. The battle still wages though in the daily lives of thousands of our silent suffering vets and the families torn apart by their addictions, torment, and suicides.
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As has been said, WWII was the last “legitimate war’; IT WAS A REAL MATTER OF NATIONAL SURVIVAL. All of the wars since then have been “politically motivated wars” for the fiancial gain of special interests. In Viet Nam there were in excess of 58,000 American personnel who were killed; countess other were maimed and wounded. The Gulf of Tonken incidents, which were used as a basis to initiate American involvement in Viet Nam, are documented to have been total fabrications, exaggerations, and lies. In the ten years of the Irq “war”, the American people get upset about there having been a little over 3,000 Americans KIA.
The Iraq “war” was initiated based upon fabricated lies and and claims about WMDs and “yellow cake”, both of which were baseless fabricated lies. The unwarranted destruction of the nation of Iraq and its infrastructures provided the chaos under which the terrorists were able to rise up and establish their organizations. Untold hundreds of thousands of Iraqis were killed, more were wounded and maimed; and millions of civilians were displaced and foisted into untold miseries. Out of the political and military disasters of Ithe unwarranted Iraq “war”, the terrorists expanded their operations into Afghanistan, Labinon, Egypt, Syria . . . George Bush’s unwarranted invasion and destruction of Iraqis the root source of the majority of the chaos and suffering throughout the Middle East.
To me it is unconscionable for the American people to allow our politicians foment these phony wars that have merely spread terrorism, civil discord, and the miseries upon so many people. In my three tours in Viet Nam, onboard destroyers, we did lead rather arduous lives, working 30 to 40 hours at a stretch, then getting 4 or 5 hours of sleep, the living conditions were arduous; but at least we weren’t in the boon docks like some were. We got shot at a few times, hit occasionally. We used to take the Navy Seals to their jump off locations for their assassinations of village chiefs and others who were sympathetic to the VCs. Those young Navy Seal guys always looked like “death warmed over”. In one 7 to 8 month period we fired more than 22,000 rounds of six inch shells . . . blowing up a lot of empty property and untold numbers of civilians as well as VCs.
I knew a fair number f guys who were out in the boon docks, the jungles. Few people can come back from that type of existence and be completely “normal”. I believe in war when it is really necessary for the protection of ournation; but the tremendous damage to people, bothmilitary and civilian, and the financial waste of the destruction is unconscionable. These phoney “wars” have done nothing more than expand terrorist movements and drained our economy; and it has gone too far for far too long. The costs in damagee to huan lives is just too great.
Thank you David for writing very elegantly the truth behind all these unnecessary wars that have maimed countless human beings. I agree wholeheartedly all that you wrote. I knew that America was stirring up a hornet’s nest that would have many years of consequences, that are now playing out in front of our eyes.
These tortured soldiers have returned to American soil, gutted emotionally. They are killing themselves on the average of 22 a day, because they can no longer live with the pain. They were lied to, telling them they were fighting for “our freedom”, when they were in fact lead to, due to massive destruction left behind, helping fill the coffers of Texan fat cats to “reconstruct”
the aftermath.
Thank you also for sharing your own personal story of your three tours in the tragic war in Vietnam.
I wanted my post to focus their suffering, as they were used as living pawns, rather than the irrationality and inherent dishonesty of these “wars” for “freedom”.
Cherry, I understood the intent of your focus about the suffering; but I wanted to point out that, the American people, are responsible to a great extent for the source of that suffering by not resisting such unwarranted political schemes that create these debacles and has now totally substantially have destroyed the coutnries and societies in the Middle East.
One of my associates consultants on the MIA-NTD project was an older gentleman who had fought in the most horrific battle in Korea; it was the battle of the Chsoin Reservoir. Arron was a young Marine then, taken directly from the transport ships to the front lines. He was one of 25 survivors out of 300 Marines, and later one of twenty survivors out of a hundred Marines. I’ve seen several documentaries of actual movie footage taken during the battle and then the retreat. As Arron used to say, life is just random happenstance when the guy on his left side, and then right side were killed by enemy gunfire. As was shown, one could step across the battle field from body to body, frozen to the ground, without ever touching the ground. Aaron expressed the feeling that one either got or lost religion on the battle ground; and in his case he said that he lost any belief in religion per se. Yet, after going through all of that, he became an electrical engineer, and he pursued quite a positive and successful career and life. War experiences either make or break most people; that which doesn’t kill you either makes you stronger or can crush one emotionally.
I once asked Aaron what was his most fearful experience in Korea? . . . . Was it the thousands and thousands of screaming, yelling waves of drugged up enemy Korean charging their positions in successive waves; The first wave or two were “farmer-soldiers” hopped up on drugs with clubs, pitch forks, etc. with heavily armed solders in the successive waves. Those first waves were just meant to use up the Marine ammo and to exhaust them. Aaron said that wasn’t the worst part of it all; they could bear that somewhat. His greatest fear was of the mortar rounds that one could not anticipate or fight against . . . that was his greatest fear. One morning when he peeked out of his fox hole, there was a large unexploded mortar round sticking out of the ground on a few feet away from his fox hole; if it had exploded he would have surely been buried alive.
Most people have probably forgotten about the Korean war or just never think about it; society has a short term memory when it comes to the physical and psychological aftermath of war. One of our Neville H.S. classmates strangled a 14 y/o VC in hand to hand combat. The last that I heard he had been in and out of mental institutions; I don’t know if he is still alive.
Last night I happened to see the movie Casualties of war, I don’t know how I had missed seeing that move in the past. However, it shows the underbelly of things that can occur in war. Generally people can learn to live and deal with physical injuries and conditions; but it is extremely difficult for many people to deal with the psychological horrors and trauma of their experiences . . . not everyone can” be an Aaron”. Even my uncle who spent 34 months as a PW in Korea and underwent the most inhumane conditions and treatments, it was the era of “brain washing”, etc. He spent six weeks in a box with a light bulb on . . . the box was too short to stand up in, and too short to lie down in. ; there was only a slot at the bottom of the box where he was occasionally given some water and occasionally some “food”. He was taken out of the box only to be tortured and brutally interrogated. But he survived that only to be sent to Viet Nam years later to train the Montanyard tribesmen how to use modern weapons. But he survived for many years, eventually dying a horrible death from the effects of Agent Orange.
Some people can experience and endure the horrors and rigors of war; and yet it is psychologically crippling to others. It either makes or breaks most people. The movie Casualties of War also demonstrates how even normal, morally decent people can be thrust into situations that causes them to do things that they might not otherwise do.I still consider myself to be very patriotic, and to be “hawkish” when it comes to really protecting American interests; but I am firmly against baseless, useless and unwarranted military actions that damage so many people, both our military personnel and innocent civilians, both physically and psychologically. The American people have to realize the impact that will eventually come down on their children, their grandchildren, and great grandchildren . . . we are all responsible for what our government does.
From someone who knows the horrors of war up close and personal, along with your testimonial vignettes of soldiers in Korea, I could not have written a better description of the pervasive cruelties endured. Some indeed can return to productive lives, as many holocaust survivors were able to do. A lot of the scarring can be emotional that can impact familial relationships, that may not be perceivable to outsiders, yet can be replicated in generations to come.
I wish too that the American people could have a more insightful awareness of our governments totally unbased military invasions. Europeans, the older ones, remember seeing their cities bombed and destroyed and the killing fields are many here that bore witness to the mass shedding of blood. Memorials and museums on some of these sites, offer interactive reinactment on some of these proved too overwhelming for me to envision. The citadel of Bitche in Lorraine, may be impressive to look at with its drawbridge, but historical suffering from many wars runs through veins in many residents of that area. Extremely sobering.