THE OLD GUY IN FRONT OF ME was using one of those canes with four rubber tips at the base as he crept towards the hospital door. It was the last week of July in Washington DC. The temperature was at least ninety degrees with intolerably cruel humidity, and he was wearing a tan golf jacket that, as I passed him, I saw was zipped up to the neck. It made me feel even hotter just to look at it. At least he had on a ball cap—one with “World War II Veteran” stitched on the front—to keep the sun off his head.
Like me, he was carrying a large brown folder. Mine held my medical records, some service documentation like orders and award certificates, and notes from my combat deployments. It was my first visit to the VA hospital.
The Washington VA medical center is as charmless a building as one could imagine: a big white box in the center of half a dozen parking lots that are constantly in overflow. In short, it looks like most big hospitals in any major city. And in many ways, I suppose, it is like any other hospital: filled with the sick and infirm, health care and administrative staff scurrying about, bad coffee. But in one very important way it is entirely different. It is the place where combat veterans enter the system for treatment of wounds, both physical and psychological.
Walking in from the parking lot, I started to feel all the familiar sensations: the stress rising in my gut, vision focus narrowed, breathing short and irregular, the memories of five wars and images of the dead hovering just offstage.
Inside the door, there was an information desk with a guy in a wheelchair behind it wearing a DAV piss-cutter cap. He looked me up and down, no doubt making some sort of judgment about me. I couldn’t imagine what it might have been. I stammered a bit, explaining that I’d come for my first appointment. My hands were shaking, so I held them down below the edge of the counter. He quietly told me where the registration office was, and pointed the way. Walking through the lobby, I imagined everyone was looking at me, thinking, “Look at the psycho boy, home from the war and broken—what a pussy.” I felt like it was my first day in high school, and I was dressed in a bright pink tutu. I took a number and waited.
The waiting room was actually a part of the main lobby, so it was noisy and there were lots of people walking past. I kept my head down until my number was called. Inside the office a woman looked over my paper work—I had brought some of my DD214s, the document that details a veteran’s military service showing training, awards and decorations, combat time served, etc.—then she started entering my data into the system. She was perfectly pleasant and did a good job of ignoring my symptoms, until she asked if I wanted to go to the emergency room instead of the green clinic. Maybe I should have.
At my psychological screening, upstairs in the mental health wing, away from the general medical patients, I was interviewed by someone new to the system, maybe a recent Ph.D. graduate, with a more qualified, I assumed, supervisor attending. I had to detail all my problems in full. I started at the beginning in Rwanda, then to Kosovo, then Afghanistan and my treatment there for PTSD, then Iraq, then Darfur and my failed suicide attempt, on and on through the drive to the hospital that morning. Staring at the floor, wringing my hands, I quietly described my memory loss, my unbridled fear and anxiety, my inability to control images of the dead appearing in my head at all hours of the day and night, my weird hyper-vigilance issues. I even included the wholly irrational things like getting lost in my own neighborhood, going to the grocery at midnight because no one else would be there, my anxiety while driving because I couldn’t control what that lunatic in the Lexus—what is it with Lexus drivers anyway?—was going to do, and why the hell didn’t anyone use turn signals anymore or return their shopping carts to the front of the store instead of leaving them in the middle of the god-damned parking lot. At that point, the supervisor sniggered.
There was an ugly silence in the small room for a few seconds with the only sounds being the air conditioning blowing through the grate in the wall and someone’s heels clicking down the hallway outside the closed door. I looked up. The interviewer looked stricken, and her supervisor quickly looked down at her notes.
Shame welled in my throat and my eyes. My humiliation was absolute; even the doctors were laughing at me. Welcome to the VA, psycho boy.
Psychiatric care isn’t a one-time shot. You don’t just show up, and say, “Hey, doc, I’m a freaking nut-job, can you fix me?” Then get a dose of Prozac and be cured. Frankly, I don’t think I’ll ever be cured. I don’t think I’ll ever be fully home. It’s a process, everyone says. So, despite my humiliation, I kept going to the VA for treatment. At each visit, and I suppose there were five or six to the main hospital, I was seen by a different doctor or psychologist. I would answer the same questions about my service and the effect it had on me. At every session I had to go into detail about what had happened to me. All the while, I wondered if the doctors couldn’t have simply pulled up from their online records the long document I had written when I filed my claim.
I felt like they were trying to get me to recant, or to catch me in a lie. Each time I felt like I was being pushed back a little in my recovery process. The providers always asked questions about whether I had felt my life was in danger, whether or not I had seen dead bodies, or if I had seen friends wounded or killed. The military doctors always used the phrase, “Do you think you are a threat to yourself or others?”
But the VA docs came right out and asked, “Do you have thoughts of suicide?”
In time, I found a therapist I could work with at one of the Vet Centers nearby, and stayed away from the big hospital. There, I was seen quickly, and the social worker was competent—himself a Vietnam combat veteran.
But still, every time I approached the clinic, I could feel the anxiety coming on. My gut wrenched and my breathing sped up. I had panic attacks in the lobby, and was barely able to walk to the elevators.After a while, the panic would start days before the visit. I was going to the clinic for treatment, and for two or three days before the visit, the stress would build. No sleep, fear, wrenched guts. But I kept going.
I also filed a claim with the VA for service-related disability. Like so many other veterans in the system, the adjudication of my claim for benefits was slow in coming. One year to the day after I filed the claim, the Veterans Benefits Agency notified me I could come to a hearing to help determine the validity of my claim. I called as soon as I got the letter and made an appointment.
The day of the hearing I also had a medical treatment appointment at the Vet Center. Even after a year of driving to the clinic for my appointments once every two weeks, I panicked on the way there and got lost. Hours later, at the appointment, I was still a mess. It’s called a Compensation and Pension or C&P hearing, but it’s held in a consultation room in the hospital and involves a one-on-one conversation with a health provider. As always, I had to explain my entire case to the psychologist. He sat at his desk with a file about four inches thick in front of him. I was in a low chair at desk-side with a lamp shining in my eyes. I had brought notes. I went through them almost line by line, detailing my symptoms—lost sleep, hyper-arousal, quickness to anger, fear, sadness, sense of isolation—the whole megillah. It took about twenty minutes.
As I walked out, I was trembling and felt nauseous. I got to my car and just sat for a few minutes. I couldn’t get control of my body or my mind. I was alone in the middle of the parking lot, crying, and staring at my hands shaking in my lap. I looked out the windshield; the image of the Darfuri boy walking in front of my truck that day five years before flashed in my mind. I could see his stained thawb, his dusty brown sandals, his unkempt hair as he tugged on the rope to pull his camel along. I looked onto the seat beside me, fully expecting to see the pistol. A sound came out of my mouth like I had just let slip a lifeline that would pull me out of quicksand, and my gut wrenched.
Three months later, I received a letter from the VA. “Dear Mr. Capps, We’ve made a decision on your claim for benefits…” I was officially a combat disabled veteran.