Things had been going well. The feeling of being on edge, waiting for an impending disaster to arrive, started to slowly fade. Then when Alayna was a few months old, Brian started feeling light-headed and nauseated. At first it was just a couple of times a month. Then weekly. Then daily. He was afraid to drive some days, worried he would pass out and wreck, but couldn’t bear to get on the bus in case he started vomiting. “I wonder if it’s related to the TBI?” he asked. “Maybe the shrapnel shifted or something?”
“When was the last time you got a CT scan?” I asked him.
“Not since I got off active duty. Seven years ago, I guess?”
“Are you serious?!” I was horrified. Part of my effort to back off and be his wife rather than his case manager meant that I was completely disengaged from his medical care. He hadn’t been to the dentist in a couple of years either, and other than occasional gentle reminders, I was hands-off this piece of his life. But this news freaked me out—I’d assumed he was getting some kind of regular follow-up care.
“The civilian doctors don’t know anything about TBI from blast injuries. They just tell me to go to the VA. But I had such a shitty experience there . . .”
“Go back. You haven’t been to VA for years—they’ve been improving.”
“Yeah, and I work there now. I guess I should.”
So Brian called the D.C. VA Medical Center and made an appointment. A whole series of appointments, actually. When he got through to the TBI case manager, she was astonished that he hadn’t been getting regular follow-up care for his brain injury or PTSD and arranged for him to see multiple providers during a long intake session. These appointments in 2012 would be the first thorough examination he’d gotten from providers familiar with blast injuries since 2005, when he was being medically retired from the Army. The first appointment was with a physiatrist. “That’s what the TBI book said you needed!” I exclaimed. “Remember? And they didn’t even have one at Walter Reed!”
At his request, I went with him to his initial appointment. The exam took an hour, rather than the fifteen minutes a typical doctor seems to spend with patients. The physiatrist spent a long time ensuring he understood Brian’s history, concerns, and goals. He ordered tests—including a CT scan to ensure there had been no changes. And he made a series of recommendations. “I want you to start taking fish oil supplements. There’s strong early evidence that it helps the brain. You need to exercise regularly, that’s been proven to help cognition. And you have to cut back on your drinking—alcohol is very bad for people with TBIs. I’d like you to see a psychologist regularly for your PTSD, and follow up with vestibular therapy for your dizziness. We have a recreational therapy program, which I recommend you try. Don’t take up kickboxing again—the jarring is not good for someone with your history. And finally, you should quit the fire department. I don’t think it’s a good idea for you in general, but especially with the lightheadedness you’ve been experiencing.”
Brian walked out with mixed feelings. “I’m glad he didn’t just say, ‘You’re lucky to be alive—there’s nothing we can do about your other problems, just be happy.’ But I don’t know about some of his advice.”
“Give it a shot,” I said. “What have you got to lose at this point?”
I was pleased that the doctor had asked Brian to drink less and exercise more. And though I knew Brian would miss the camaraderie and service of volunteering with the fire department, I was secretly relieved about that, too. The nights he spent on duty (once a week from 6 p.m. to 6 a.m.) were tough on me, home with both kids. I’d quit when Duncan was born, but Brian had stuck with it. Though I tried to be supportive, it was challenging. This had deepened my empathy for military families—here I was stressing about being on my own with the babies overnight once a week, they had to deal with multiple year-long deployments. It was hard on Brian to quit, though. He held on to his gear for another year before finally turning it in. We stayed in touch with the department, bringing food in on major holidays and trying to support it in other ways.
FOR RECREATIONAL THERAPY, Brian started a golf program. Once a week, he and a group of other wounded warriors would head into the Armed Forces Retirement Home golf course and get a lesson from a professional golfer. “If I finish the whole session, they’ll give me a free set of clubs!” he told me.
“Don’t you have a set your dad gave you?”
“Yeah, but they don’t fit me right. I’m way too tall for them—and they’re like twenty years old. These would be used, but much newer and nicer.”
I shrugged. It was great that he was enthusiastic, but I’d seen Brian excited about new activities before and wasn’t convinced it would stick. His habit of going all in on a series of short-lived enthusiasms had long been a source of friction in our marriage. Brian would try something, enjoy it, and insist on buying a ton of accessories . . . only to abandon the hobby just as quickly.
After our ski trip to Colorado—the one I spent with my leg in a cast—he’d insisted on buying a snowboard. “Can’t you just rent one?” I asked. “We don’t go very often.”
“No! They might not have my size because I’m so tall—and the quality is never good.”
And of course it couldn’t just be a snowboard—there were boots, a jacket, a helmet, goggles, gloves, stickers, magazine subscriptions—he went all in. After he used the snowboard twice in one season, Brian announced, “The snow on the East Coast sucks for snowboarding,” and abandoned it in the corner of the garage.
A couple of years later, he tried surfing during a summer vacation to the Outer Banks. Soon surfing magazines started showing up in the mailbox. The next year he insisted on buying a surfboard the day we arrived at the rental house on the beach. And two wetsuits, short- and long-sleeved. Days later, he took a surfing class. “Can I buy a new surfboard?” he asked me after the session. “This one is the wrong size for me.”
“Can you return that one?” I asked skeptically.
“No, it’s already been used.”
“Then I think it’s a really bad idea to buy two surfboards inside a week. You have to make your own decision about this, but financially I think it’s a really bad move.”
He fussed and pouted, but didn’t buy a second surfboard.
I seethed. Why did Brian have to buy so many things, instead of just renting or making do? I wondered if this was a remnant of the TBI—the impulse control portion of his brain had been damaged. Although Brian had gotten better about not buying expensive things without at least discussing it with me first, I supposed there was a chance that his infatuation with trying new activities and buying all the accompanying toys was linked to that.
When Brian had started kickboxing at a local gym, he’d bought shorts, gloves, and wraps, and signed a long-term contract—and then had to abandon it when he blew out his knee. He’d bought a fancy helmet when he got into hockey—then never used it after we went to a rink once and he decided his balance was too off. An expensive bike to replace the cheap one he already had when I suggested family bike rides—hardly ever used. A comprehensive set of equipment for brewing beer—rarely used, though we had gathered an extensive set of pint glasses. Drinking beer—that was a hobby that stuck. I’m pretty sure the first thing Brian said when the doctor confirmed my pregnancy was, “Sweet! Designated driver for nine months!” Everywhere we went on vacation required a trip to a local microbrewery for a tour, a sample—and a T-shirt and pint glass.
He’d even been on a vehicle binge: first he bought a Baja Bug to work on. Then he traded that for a motorcycle. Insisting that wasn’t the right size, he bought a Harley. For a while we had two motorcycles in the garage, until I threw a fit and he sold the old one. Sure enough, biker gear started proliferating. He complained that the Harley wasn’t the right size and took it apart to make modifications . . . then, when Brian was unable to fix it, it sat, nonfunctioning, in the garage for months.
So this golf thing, I assumed, would be just another hobby that would require the purchase of lots of accessories and an initial investment of time before being cast aside. And sure enough, golf magazines started showing up in the mailbox. Golf books filled the memory of his Kindle. A growing assortment of bold golf pants started to work their way into his wardrobe. I just shook my head, waiting for it to pass.
But it didn’t. Brian finished all the sessions, and started going on his own to the local courses. Sometimes he just hit balls at the driving range. Other weekends he would let the course match him up with other singletons to play a game. “You . . . meet strangers?” I asked. Brian usually insisted I make all the phone calls to arrange appointments and was highly averse to situations where he would have to talk to people he didn’t already know. It always surprised me—when he was with friends or drinking, Brian was gregarious, outgoing, expansive, and wildly funny. But if I tried to drag him on a double date, he was reserved and withdrawn almost to the point of embarrassment. The thought of him voluntarily spending hours talking to strangers on the golf course was amazing.
“I almost had a panic attack on the bus today,” he said one day after work.
“Oh yeah? Did you take a Valium?” I asked absently, trying to spoon baby food into Alayna’s mouth while Duncan threw Cheerios onto the floor.
“Nope. I used a mindfulness technique from golf.”
I set the spoon down and turned to face him. “What?”
“I’ve been reading about sports psychology in those golf books. About how even pros can choke when they’re playing. It had some techniques they can use to calm down and refocus. So when I felt the panic attack coming on, I tried it out. And it totally worked!” Brian was smiling, pleased.
It elicited a grin from me in response. “That’s amazing! I guess the VA really knows what they’re doing with that recreational therapy stuff. I kinda thought it was bullshit, but that’s awesome!”
I got up and hugged him. Duncan and Alayna insisted on being gathered up for a group hug. It felt good—like we were a real, normal family.
AFTER IRAQ, I DIDN’T cry when people died in movies. Well, adults anyway. Babies and dogs dying left me a blubbering mess, but adults? Fuck ’em. We all die. They weren’t angels. I’d gotten so used to the prospect of imminent death in Iraq that it just wasn’t that big of a deal anymore. I expected to die. It didn’t bother me. Shouldn’t everyone feel the same way—especially religious people who expect a glorious afterlife? You’d think they’d be actively excited about the prospect.
Around the time when the end of the Iraq war was formally declared, Alayna was about six months old and my son was a little over two. One day, while I was sitting on the floor playing with them, Duncan was being remarkably sweet to his baby sister, leaning over to kiss her repeatedly while she giggled with delight. As I watched them, smiling, it suddenly occurred to me: “When I die, I’ll never get to see them again.” Tears sprang into my eyes and I gathered them suddenly into my arms, squeezing them until they squirmed to get away. “I don’t want to die,” I realized.
It felt simultaneously profound and ridiculous. Of course I didn’t want to die. But it wasn’t until one marriage, two children, and eight years after getting back from Iraq that I was able to truly open myself up to that knowledge.
Loving and caring for children had changed me: it made me feel more affection and empathy for others as well. Yes, I have loved Brian for years. But the love was deeply tangled in a sense of responsibility and fear, shot through for much of that time with threads of anger and resentment. I rarely felt genuine empathy for what he was going through, focusing instead on trying to find solutions or a way for us to get through the results together. And I’d had virtually no sympathy for my parents when I deployed, for Brian’s parents when we got home, for military families more generally. We were getting shot at—what were they going through? Knowledge of how safe and secure they were back here obscured from me the different type of suffering they go through.
Looking at my own children now, I try to imagine them grown—and maimed. It’s nearly enough to make me want to take to the streets carrying protest signs and marching for peace. Reporters have asked me, “Would you let your daughter join the Army?” And I’ve answered as honestly as I could: “If it’s what she truly wanted to do, I would support her. Same with my son. Because if I didn’t, they would do it anyway, and I might lose the ability to be there for them. But do I want either of my children to go to war? Of course not.” I bite my knuckles watching them climb on playground equipment worrying they might fall—how do parents take watching their children head off to a combat zone?
I wonder if it’s the hormones of pregnancy, childbirth, and breastfeeding—the flood of oxytocin, a hormone that is linked with empathy, trust, and love, thought to facilitate bonding and reduce stress hormones. Is the cause of some of my changed feelings chemical? What about Brian? Research shows that fathers of newborns also experience spikes in oxytocin levels.1 For years, I had resigned myself to a future with little cuddling, affection, or eye contact—Brian just didn’t seem to enjoy non-sexual physical contact and generally didn’t meet my gaze. But he snuggled readily with Duncan and was an active, engaged father, staring into Duncan’s eyes, talking to him, playing with him. Gradually this spread to me as well; we started holding hands more often, sitting closer together. Was it possible that loving this tiny baby was letting us learn to love each other more deeply? Could it be helping Brian more generally?2
Perhaps the mechanism is unimportant. Whether spending time with our babies sparked physiological changes inside our brains or not, it certainly opened our hearts.
THE TEN-YEAR ANNIVERSARY of Brian’s injury is coming up. A lot of people in the veterans’ community call it their Alive Day. Brian calls it his Phoenix Day—I strongly prefer that term. The imagery of the phoenix arising from its own ashes is powerful. It isn’t just about staying alive, it’s about renewal. The journey Brian and I have been on hasn’t been trying to survive and get back to the way things were before, it has been about forging a new normal—one that is in many ways better than the old.
There’s been so much talk about post-traumatic stress, including arguments about whether or not to drop the “disorder” and simply call it PTS, or change the D to an I for “injury” to emphasize that it has a precipitating event rather than being caused by some inherent weakness, as part of efforts to destigmatize help-seeking, particularly among combat veterans.3 The flip side, post-traumatic growth, has been largely ignored.4 But that aspect to the aftermath of trauma is just as real. I came home keenly aware of how lucky I am to live in America today, where I have access to health care, electricity, the comforts of modern life—and where the chances of my loved ones dying due to a terrorist attack pale in comparison to the likelihood they will die from diseases caused by overconsumption.
And over time, Brian and I both came to deeply feel our connection to our fellow citizens and be highly conscious of the responsibilities that laid upon us to contribute to society. We are both convinced that having suffered, going through the crucible of war, drove development of our morality. Hermann Hesse said, “Who would be born must first destroy a world,” echoing Carl Jung’s “There is no coming to consciousness without pain.” And so, like a chick hatching from its shell or the phoenix rising from its ashes, rebirth and renewal sometimes only come from wrenching displacements of the world you knew.
Getting to where we are today has not been easy. I liken it to the stock market—a jagged line with lots of ups and downs, but over the stretch of years the upward trend is clear. People have often asked me why I stayed, and I still can’t answer that question satisfactorily. My motivations are tangled. I loved my husband, but didn’t always like him. I felt an obligation to care for him, one that was mixed up in the military ethos of “Leave no fallen comrade behind.” But sometimes the desire to run from that responsibility was so strong that I had to find ways to tie myself to him for fear that I wouldn’t stay—getting married, having a public wedding, buying a house: all of these things served as ways I could bind myself, make it harder to leave in a fit of pique. I’m not a religious woman, but in the early years I sustained myself on faith: a steadfast conviction that he would get better, if I tried hard enough, waited long enough, hoped hard enough, he would get better. And he did.
It’s made me feel terribly awkward when giving dating advice. When boyfriends treat my friends like garbage, I say, “Leave him!” And they say, “But you stayed. And now look at Brian!” It seems I’ve lived out the fantasy I shared with so many dumbass girls in high school: if you just love that bad boy hard enough, he’ll change! I have to explain, “But Brian had a TBI and PTSD—there were reasons for his problems, and a path to recovery. There’s no therapy for asshole.”
Early on in our marriage, Brian would accuse me of trying to change him. “This isn’t about me changing you,” I responded. “This is about the changes that naturally occur when you grow up. Cleaning the house, paying bills, being responsible—that isn’t me trying to turn you into someone you’re not. That is me expecting you to go through the transition that everyone goes through when they become adults.” It baffled me. Shouldn’t all this have already happened during his first marriage, or when Sonja was born?
One day he confessed, “Sometimes I feel like . . . all the development that was supposed to happen, when I got the brain injury, it just halted. I stopped progressing.” But he hadn’t stopped—just paused.
During some of the rougher times, two memories helped sustain me. One was a friend of mine from high school, who built a lasting relationship with his girlfriend after they had a daughter together, telling me, “I don’t always love her, but I always like her. There are weeks or even months when I’m not that physically attracted to her—I’ve even felt attracted to other women. But I’ve always been profoundly interested in her, how she thinks and who she is. And I respect her. I genuinely care about who she is and where she’s going.”
The other was Anne’s mother telling me about her relationship with her second husband. “Whenever one of us comes home from work, we hug and kiss each other first, then the kids. And we make a point of spending at least fifteen minutes a day talking, just the two of us, no matter how busy we are. Because the kids are going to grow up and leave the house, get married, have kids of their own—and we need to still have a relationship when that happens! We are going to be together for the rest of our lives, so we have to invest in our marriage.”
Those two conversations helped shape my understanding of what relationships are about and see them as long-term propositions. It isn’t about being happy every day. There may be months or even years that are a hard slog. But with a solid foundation of love and respect, with shared values and goals, the investment of sticking together through those tough times pays off in the long run. Perhaps our shared experience of war also helps bind us closer together—certainly it gives us a more visceral understanding of what the other has experienced.
And here we are.
Brian still cycles through periods of depression that come on out of nowhere, leaving him low and joyless for weeks or months, which can only be kicked with a new round of medication. He still has headaches, sometimes short stabbing ones that double him over in agony for just a few minutes, others longer and lower, driving him into bed for hours. And his unpredictable bouts of PTSD symptoms still force him to carry his tiny vial of Valium to ward off anxiety attacks. We wonder if he will be hit with early-onset dementia (common for those with TBIs), if the shrapnel may shift, or if the future holds other physical or mental ailments due to the IED.
Doing research for this book, I tracked down Dr. Armonda, the neurosurgeon who operated on Brian in Baghdad. Brian hadn’t been sure the doctor would remember him, but Dr. Armonda recognized him immediately. It was powerfully moving to see him grinning ear to ear at Brian’s incredible recovery. It hadn’t occurred to me that battlefield surgeons often don’t know the ultimate prognosis of their patients, that their secondary trauma might be exacerbated by that lack of closure. While we talked about Brian’s journey toward healing, Dr. Armonda congratulated us on our successful marriage: “You know, only 20 percent of TBI patients are still married five years later.” The statistic shocked me. I knew the path we traveled had been hard, but had no idea so many other couples didn’t make it. Our marriage isn’t perfect. But it is solid.
Having children has actually—counterintuitively—improved our sex life. Before we had kids, it was easy to push it off to the next day if one of us was tired or busy . . . and then have the same thing happen again and again until seemingly all of a sudden it had been weeks. Some of the medications Brian was put on decrease sex drive, which could throw us off for months. And some of his symptoms, like the flattened affect, angry outbursts, and negative worldview, also made it much harder for me to feel sexually attracted to him. My hormonally induced shifting sex drive and changing body during and after pregnancy made me much more aware of how factors outside one’s immediate control can influence desire, and helped open new lines of communication between me and Brian about sex. We realized that having to juggle all our schedules meant we had to add sex to the mix or it could get lost entirely, so even if we’re not both in the mood when opportunities arise, we take them anyway, aiming for twice a week. There’s a good chance that the intimacy will spark arousal, and even if the time available or level of passion is constrained by circumstances, our relationship benefits from simply having regular sex—it reminds us that we are husband and wife, not simply parents and household partners.
Sometimes we still wonder what we want to be when we grow up. Neither of us is completely satisfied with where we are or what we do. I contemplate leaving RAND to work more actively in the veterans’ community. Brian is considering going back to school. We toss around small-business ideas. But both of us know that our vague itching to improve our lives even further is a clear sign of our profound privilege.
As the kids get older, we want to find new ways to volunteer. Getting involved in projects larger than ourselves and committing to our community has been an important part of our road to recovery, but having two young children has eaten into our available time. We are anxious to find new ways to connect.
Brian and I have sacrificed more than most for this country: a tiny fraction of our peers have served in Iraq or Afghanistan, compared to the large percentages of citizens who signed up to fight in WWII. And though significant numbers of veterans from today’s conflicts have come home with some type of physical or psychological wound, few have sustained the type of severe penetrating brain injury Brian suffered.
And yet.
We have lain wreaths on the graves at Arlington. We have seen those who have come home so profoundly injured that they will never be functionally independent. Our sacrifices pale to nothingness beside the grief of those families.
We are living proof that for many struggling with physical and psychological wounds of war, there is a path back from the brink of despair to a meaningful new existence. Though it is a rough road, with the right support it can be navigated. All of us, as citizens, have an obligation to ensure that services are in place for those who need them. Brian and I hope that our example and our efforts ease the way for those still coming home.
We are blessed beyond imagining, being able to look back over the decade we’ve known one another, assess the ebb and flow of our relationship, and imagine where it will go as we move forward. The wars we fought, both overseas and here at home, may have shaped us, but they will not define us.
1. http://www.livescience.com/10784-dads-hormone-boost-caring-baby.html
2. http://www.myhealthnewsdaily.com/608-oxytocin-therapy-psychiatric-illness-101205-.html
3. http://articles.washingtonpost.com/2012-05-05/world/35454931_1_ptsd-post-traumatic-stress-psychiatrists
4. http://www.nytimes.com/2012/03/25/magazine/post-traumatic-stresss-surprisingly-positive-flip-side.html?pagewanted=all&_r=0