I’m Broken
November–December 2004
Life goes on back home while soldiers are away at wars. Wives and husbands sometimes cheat, teenage daughters get pregnant, sons get arrested, jobs are lost, and thousands of homes are foreclosed on while we’re away serving our country. Too often, while we’re right in the thick of fighting our nation’s wars, death finds the soldier in a combat zone—on the battlefield, by the death of his parents, or perhaps by the death of an innocence he once had.
I left Iraq on October 31, 2004, Halloween night. As I headed to the military air terminal in Baghdad, I mourned the small measure of innocence I still had when I arrived in this place. I was kind of anxious about getting on the plane because of an experience I had two months earlier, when I had to fly into Kuwait to pick up my 9mm pistol that was confiscated when I arrived on a civilian flight without all the right paperwork to bring my weapon into the country. On that flight, the remains of a dead soldier were loaded onto the C-130. As the truck with the coffin approached, the crew chief asked us all to exit the plane and form two lines, one on each side of the huge truck. All activity on the entire runway and military air terminal stopped at that moment. As the coffin was slowly removed from the truck, the order “present arms” was yelled out. We all came to attention and saluted our fallen comrade who had died on the battlefield. An Army chaplain positioned himself in front of the coffin and said prayers as he led the coffin into the C-130.
Most often, planes heading out of a combat zone are filled with chatter, laughter, joy, and fun as troops head home. But not on that day. It was a somber occasion that reminded us all of how lucky and how fortunate we were, and that one soldier on the flight had made the ultimate sacrifice for his country.
The images of that flight kept running through my mind as I boarded the Air Force C-130 cargo plane for the first leg of my flight out of Iraq. Unlike all of my previous flights to and from Baghdad, I was the only passenger this time. Usually there would be dozens of us stuffed in this hot plane like sardines, breathing diesel fumes and each other’s stink. Having the plane to myself this time didn’t make it much more comfortable, however. I overheard one of the crew members say that it was 145 degrees on the flight line. Once we were squared away and ready to go, we sat in place with the propellers running for forty-five minutes. Why? I have no earthly idea. All I know is that I was soaking wet with sweat down to my underwear. Finally we got the go-ahead for departure and the plane began to roll quickly down the runway. Even though I had done this drill many times, I was still surprised to see how fast this big-ass C-130 could take off, and in such a short distance. I sat up straight, strapped in with a seat belt, and braced myself for the combat takeoff maneuvers that I knew were coming, the departure equivalent of the same wild ride that I had taken when landing in Iraq the first time. Within an instant it seemed as though we were facing straight up. As the big plane went vertical, twisted, banked, and yanked left and right, I was almost lying down sideways from the force. Then the plane’s engines howled, we banked down with a sharp turn to circle the airport, leveled out, and headed south to Kuwait City. I was able to sit up again as the plane flew straight and level. The air became cool as we gained altitude, and my sweating stopped.
After the takeoff-induced adrenaline surge wore off, a sense of calmness fell upon me. As I dozed off to sleep, the loud rumble of the C-130 providing a constant din that helped block out everything but my inner thoughts, I kept wondering who I would be after this experience. Will I be different when I get back home? Will I get post-traumatic stress syndrome? Am I gonna have nightmares? For the moment I decided to enjoy the bliss of being at 10,000 feet, safe, out of harm’s way, and heading home. I drifted off to sleep.
We landed safely at Camp Doha Air Force Base right outside Kuwait City. A couple of young soldiers were nice enough to help this old colonel carry his gear to the VIP quarters where I would reside for approximately the next two weeks. These VIP quarters were very much different from the VIP tents in Baghdad. The VIP tents in Baghdad were like all the other tents, filled with cots and large air-conditioning units that worked on occasion. The only real upgrade for the Baghdad VIP tents was the sign on the outside of it that said “VIP.” The Camp Doha VIP quarters, on the other hand, were significantly better than any accommodations in Baghdad and the standard tents in Doha. These quarters were in a large structure that had tin roofs and tin doors. The rooms had regular beds with linen, a TV, refrigerator, a phone, and, most importantly, regular showers and toilets. After spending time in Baghdad, these quarters looked like a five-star hotel.
I got to my room, put my gear away, took my 9mm pistol from its case, and removed the clip that held the bullets before I locked it away. I headed for the shower and took a hot soak for what seemed to be an eternity. While walking back to my room, it seemed as though the weight of being in a combat zone had been quieted by the hot shower. I got dressed and called my wife to tell her that I had survived the perils of Abu Ghraib and had arrived safely in Kuwait. She cried that night, as did I, thanking the Lord for allowing me to return without the loss of life or limb like so many other brave soldiers. I would soon be in the comfort of her arms again. Afterwards, I called my eighty-one-year-old mother, wanting to assure her that I was all right and also to thank her for steadying me on that first terrible night in Abu Ghraib.
She didn’t sound good. Her voice and spirit had been weakened from the forty-year battle of being an insulin-dependent diabetic. Neither I nor my sisters knew it then, but she was dying.
I lay down on my bed to just unwind before I headed to the chow hall for the midnight meal. I was overcome by exhaustion and slept for three hours. At 3 a.m., I heard a loud bang—BAM!—followed by voices in the hallway outside of my room. Groggy and disoriented in the utter darkness of my room, with no lights to help me find my bearings, I responded as I would have in Abu Ghraib. We’re under attack! With one quick, fluid motion, I rolled out of my bed onto the floor, got to my feet, and managed to find my flashlight. Hurriedly, I found my way to my 9mm pistol, locked and loaded it, and turned the safety off. The voices outside of my room grew louder. Now sweating, a voice in my head was screaming at me. Hurry, Larry! They’re coming for you! They know you’re here and they’re coming for you! Get ready to engage! With my loaded pistol in my right hand, I quietly eased my way to the door.
BAM! The loud noise came again in the night, making me flinch and crouch lower to the floor. Damn, was that another mortar? My heart was racing as I eased open the doorknob with my left hand while keeping my right index finger on the 9mm pistol trigger. I opened the door, 100 percent ready to engage, and saw two sixty-year-old American women standing outside my room laughing and talking. One of the ladies saw me there, crouched and ready to blow her fucking head off. She either didn’t realize what the look in my eyes meant or she was trying to defuse the tension, because she didn’t react like someone in the line of fire.
“Shucks, son, sorry we woke you up,” she said softly, very gently, and with a bright smile. “Son, just go on back to sleep. You look exhausted.”
The look on her face and her gentle tone immediately slowed my racing heart, and after a moment in which I just stared at her, trying to understand what was happening, my thoughts slowed and the fear eased. As I lowered my weapon, I heard another BAM! and turned toward the sound just in time to see a door closing behind someone. Every time someone opened the tin doors at the entryway to the building, they slammed shut with a sound much like that of a mortar’s impact into the side of a building at Abu Ghraib.
I got up and hurled myself back into the bed, still clutching my pistol. I lay there trying to understand what had just happened, and at that point it was clear that my psyche had served notice: I was not the same man, nor would I ever be. Even though I was able to quiet my mind again, I knew that the anxiety would reappear. Intellectually, I realized I was safe and out of Iraq, but some part of me still questioned the safety of my surroundings. It was just a door this time, Larry, but that doesn’t mean you’re out of harm’s way. You’re still on the list. They still want to find you.
I placed the pistol on my nightstand and slid my bayonet within arm’s reach under my bed. Assured that I had my weapons within reach, I dozed off back to sleep. Then I had a horrible nightmare. I dreamed that I was on a convoy, hot as hell in the 130-degree heat, soaking wet with sweat, and sitting directly behind the driver, when my Humvee got a flat tire. As we pulled over to the side of the road, my driver got shot in the head. His blood and brain matter splattered my goggles and face as I sat there behind him. In the ensuing frenzy to defend ourselves, my M16 jammed and I dropped my 9mm pistol. I hurriedly found my sidearm, and as I looked up with my 9mm ready to fire, I could clearly see the eyes of a fifteen-year-old Iraqi boy ready to shoot his AK-47 at the soldier standing to my right. Instantly reliving every moment of doubt and moral debate that I had pondered over this moment, I nonetheless pointed my weapon at the boy, pulled the trigger to save the life of a fellow soldier . . . and then I awoke in a panic, chilled in cold sweat, in the quietness, the utter darkness of my room.
My heart raced in a loud thump, thump, thump as I struggled to orient myself, to find my way. I only partly realized that I was awaking from a dream. Part of me was still blood-spattered in that convoy, and part of me thought I was waking up but in the midst of a real attack on the base. The voice in my head was screaming, GET YOUR WEAPON, LARRY! HURRY! HURRY! THE FIGHT’S ON! Then, as I frantically struggled in the dark to figure out where I was and what to do, I could hear my wife’s voice in the distance.
“Sugar, it’s gonna be okay, it’s gonna be okay,” she whispered, repeating the mantra that always calmed me down when it came from her beautiful lips. “You just had a bad dream, sugar. Settle down. It’s gonna be okay.”
Finally realizing I wasn’t being attacked, I got up and listened for voices outside my door before opening it. I didn’t want to bump into anyone and have to chat. Hearing nothing, I opened the door and walked down the hallway to the bathroom. I poured cold water in my hands and splashed the ice-cold water on my face.
Damn, Larry, is this what it’s going to be like now? I thought. Is this what I’m going to face every night?
Falling back in to my bunk, exhausted all over again from this turmoil and moral haunting, I was able to drift away back to sleep for the rest of the night. I got up around lunchtime and headed for the chow hall. But as I walked to the chow hall I stopped right in the middle of the sidewalk, transfixed by an empty Pepsi can laying in the middle of the sidewalk. Oh shit, it’s an IED. Slowly, never taking my eyes off the Pepsi can, I took a few steps backward while the young soldiers behind me just kept walking forward, past the can. I crossed the street and continued on for another block, then I stopped again in the middle of the sidewalk. This time it was a brown paper bag that paralyzed my movements and focused my attention. Again I whispered to myself, “An IED, Larry! Hurry! Cross the street! It’s gonna blow any minute!”
I hustled across the street, eyes peeled for another IED, ready to dart away at the slightest suspicion. In this way I eventually got to the chow hall as the soldiers around me just strolled casually along.
I soon learned that this cautious process was very common for soldiers on their return home. In Iraq, IEDs were placed in the simplest of life’s things, a Pepsi can, a brown paper bag, or even the carcass of a dead cat or dog. Still to this day, although I am not as hypervigilant as in those first days out of Abu Ghraib, an empty bag or a soda can on the sidewalk will get my attention, maybe even spook me if I only see it at the last minute. At night, even though I try to relax and remember that I’m not in a combat zone, I still peek out my window and stare at every car that turns around in my cul-de-sac.
Along the way to the chow hall, as I crossed the street for the umpteenth time, a voice from deep in my soul spoke up. Larry, turn in your ammo for your 9mm pistol. Turn in your ammo before you shoot somebody, you dumbass. I realized I was just too damn jittery to be carrying a loaded weapon. So I asked where to find the supply building. “Hey man, where can I turn in my rounds?” I asked one young soldier, as I rested one hand on my 9mm. “I shouldn’t be walking around with this.”
He smiled and nodded his head like he knew what I meant. “Colonel, I understand, sir,” he said. “It wasn’t a good idea for me to have my weapon loaded here either, sir.”
We both laughed while he gave me directions to the supply building. A few minutes later I turned in two 9mm clips with all of the bullets. However, I kept my KA-BAR bayonet. I just didn’t want to be unarmed, even here on this relatively secure base. Although my fear was misguided and irrational, something would not allow me to let go of my hypervigilance. I couldn’t help but anxiously think about an intel officer at Abu Ghraib telling me that there was a $25,000 bounty on my head from Al Zarqawi and that I and the other colonels on post were on Al Zarqawi’s most wanted list. I never bothered to check “the list” and verify it myself, because I didn’t see the point. If my specific name wasn’t actually on the list, would that mean I wasn’t threatened? No, I’d never assume that. And if my name was on the actual list of most wanted, I didn’t see how I would be helped by having that image seared into my mind. I was cautioned to be damn careful and watch my back at all times, no matter where I was—and I did. Each night before I went to bed, I placed my bayonet on the nightstand right next to my bed.
After I ate lunch, I decided to walk over to the food court and visit the Starbucks. Seeing the Starbucks was more of a welcome sight than most people could imagine. I’m a coffee lover who’s always walking around with a Starbucks cup in my hand back home, but this time that green-and-white sign meant much more to me than that I would soon get a cup of hot coffee. It was a symbol that said, “Yes, Larry, you really did survive Abu Ghraib and you’re back in civilization.” It confirmed to me that I was one step closer to going home. Sitting in the Starbucks sipping that warm cup of coffee, I had time to reflect on the difficult night. Why did you have that nightmare last night? I asked myself. It was like my psyche, my superego was sitting next to me at Starbucks talking to me, playing the role of therapist. A voice told me, “Larry, perhaps your nightmares are a metaphorical struggle between good and evil. It is actually a good sign. Son, if you did not have nightmares, given the horror of what you saw, you would have normalized these horrible events. Welcome your nightmares, Larry. This is how your soul is telling you that the horror of war is against a decent man’s morality.”
I took a long time to finish that cup of coffee, thinking through the nightmares and what they meant about how I was handling my experience at Abu Ghraib. I never had that nightmare again. Three years have passed since I returned home and I no longer fear going to sleep.
I stayed at Camp Doha for more than a week waiting to get a seat on a flight home. I was able to power down by getting some sleep in spite of the constant bang of the tin doors. I stopped jumping at the sound, but I often lay there wondering what genius designed the place with doors loud enough to be mistaken for mortars. At the base, I would go to see movies, one of my favorite pastimes, and I called my wife every day. Eventually, along with four hundred other soldiers, I boarded a chartered DC-10 en route to the States. We stopped in Germany, Italy, Nova Scotia, and finally landed at the Baltimore-Washington International Airport’s military air terminal. We all cheered as the plane touched down on U.S. soil, some cried, and we all congratulated one another. There was an Army chaplain on board who came on the microphone and said a prayer for the soldiers we lost along the way and asked the Lord to keep them safe. I spent the night at a local hotel in Columbia, Maryland, then boarded a United Airlines plane on to Honolulu two days later.
My wife, Janet, had finally closed on our brand-new home and moved out of the hotel, along with our three-year-old granddaughter, Judy. A rare feat for me was that I slept almost uninterrupted for every leg of my fifteen-hour journey home from the Baltimore airport. Even though I could now get to sleep without nightmares, the inner turmoil that once made its way into my dreams would return in different ways I had not yet envisioned. My arrival at Honolulu International Airport was met with great joy. Being back in the arms of my soul mate of thirty years would always heal and calm me. Along with Janet, my granddaughter, son, and close friends, there were members of my command at the airport to great me. It was a wonderful homecoming.
Settling in quickly at our new home, I slept peacefully in our waterbed. I soon called my mother in New Orleans to tell her I was home safe, but I was dismayed to learn that her health was continuing to fail. Within a matter of days Janet and I were on a plane headed for New Orleans to spend perhaps my last Thanksgiving with my eighty-one-year-old mother. We arrived in New Orleans about three days before Thanksgiving 2004. When my mother saw me, she hugged me as though she knew her time had come, that perhaps it would be the last Thanksgiving with her only son and youngest of six children. I busied myself with chores around the house, enjoying the richness of my Creole culture and spending as much time with my mother as possible. It was indeed a joyous time.
My mother was a night owl like both Janet and me. We enjoyed spending late nights in the French Quarter and bringing my mother home a hot cup of French café au lait and beignets, wonderful French doughnuts, from the legendary Café Du Monde. On this particular night, my mother and I were up late by ourselves, laughing, as she told stories about her youth on a farm in Opelousas and Simmesport, Louisiana. We were enjoying our time together when suddenly she became quiet for a moment. Her expression changed and she said, “Son, I know the Lord has sent the angels for me. I spend more time in the hospital than I spend out of the hospital. I only wanted to live long enough to see you one last time before I go, son.” She was looking at me as if this was the moment she had held out for, the time she wanted to just be with me and look into my eyes. Somehow I was able to hold back my tears, but she knew what I was feeling. Realizing my pain and sorrow, she shifted the conversation back to her youth in rural Louisiana, Cajun zydeco music, and how she would dance up a storm as a teenager. We laughed some more, long and hard, then we finished our café au lait and beignets. Reluctantly, but so grateful for the time with her, I went to bed at about 2 a.m.
The morning before Thanksgiving, I loaded my mother in the car and drove her to one of her thrice-weekly kidney dialysis appointments. They had been a consistent burden for her for many years. As I started the car, she placed her left hand on my right arm and said, “Son, I need to talk with you about something. I need your help with it because your sisters will listen to you about this.”
“Yes, Ma dear,” I said. “What is it, sugar?”
“Son, I don’t want to do this any longer. It’s my time to go be with your sister Betty, Daddy, and my mother.”
I knew what she meant, and I wasn’t going to disagree with her. “Ma dear, of course, darling, how can I help you with this?” I asked.
Holding on to my arm, she responded by saying, “I need your blessing to just let go. Is that okay, son?”
I struggled to hold back my tears, but I told her what I really felt in my heart. “Ma dear, you’ve lived a long, good life, and if you know that it is your time to move on and be with the good Lord, then that is okay by me. And it will be okay for all of my sisters. Sugar, when you’re ready to let go and go to be with my sister Betty, just let go. It’s okay.” My sister Betty died at age fifty-two, due to complications from lupus. My mother, like all parents, felt that no parent should have to outlive one of their children. Perhaps my mother welcomed death so that she could be with her daughter again.
She said, “Thank you, son,” and I confirmed that she still wanted to go to the kidney dialysis center today. She did, but along the way we stopped for a café au lait. The next day was a joyous Thanksgiving celebration. My entire family came by my home in New Orleans on Thanksgiving. That night Janet and I went out dancing to zydeco music, and we of course brought my mother back a café au lait and some French doughnuts. My mother laughed with me and told me stories about my Creole ancestors I had not heard before. Again, we stayed up talking together until about 2 a.m. Through this process I was slowly starting to heal. Being with my wife, my mother, and all of my family in the place of my birth was calming for me.
However, our joy was short-lived. The next morning my sister woke my mother up for dialysis. Something was not right. My mother’s speech was slurred and her thoughts were kind of disorganized. She had had a massive stroke in the night while asleep. We took her for what would be her last and final visit at Touro Infirmary in New Orleans. Janet and I stayed in New Orleans until Christmas Day and flew back to Honolulu on Christmas night 2004. My mother remained in the hospital and died two days after our plane landed in Honolulu.
Death always has a way of finding a soldier. Death does not stop, nor will life events slow because a soldier is deployed for fifteen months. I was not prepared for this level of loss less than a month after my return from Iraq.
The rest of December and the remaining holiday season of 2004 flew by with a looming sense of loss and sorrow, while at the same time I struggled to recover from my Abu Ghraib emotional scars. On one Saturday morning in late January, the haunting, the residual effects of the war, found its way to my soul again. It was like most Saturday mornings for Janet and me. We stayed up late on Friday after our granddaughter went to bed and we would rise late on Saturdays. On this one Saturday morning, something was amiss for me. I can’t tell you to this day what was at the core of my discomfort on that morning.
I sat in my favorite leather chair upstairs and wore my favorite comfortable pajamas while I watched a movie on HBO. For Larry James, that should be a damn good morning. But something wasn’t right deep inside me. I could hear Janet and my three-year-old granddaughter, Judy, downstairs having so much fun. Like most three-year-olds my granddaughter insisted on making her own cereal that morning, slowly pouring milk into the bowl with the cereal. I could hear Janet praising her for doing such a good job, not spilling a drop on the floor. Then Janet grabbed the morning newspaper on the front porch, some coffee for me, and walked up the stairs with our Judy. On the very last step of the stairs, Judy stumbled. Milk and cornflakes went flying on the carpet, the walls, and everywhere. Within the blink of an eye, a demon was unleashed in me that I had not ever seen before. “WHAT’S THE MATTER WITH YOU, JUDY? ARE YOU STUPID?” I yelled at the top of my voice. “GODDAMN IT, I’M SO TIRED OF THIS SHIT! SIT YOUR ASS DOWN AND CLEAN UP THIS CRAP!”
Neither Janet nor Judy had ever seen me rage like this before. This was totally unlike me. My world went into slow motion as my three-year-old granddaughter became afraid of me. I saw it in her eyes. She screamed, cried, and begged for forgiveness as loud as her lungs would allow. I yelled again, “SHUT UP, GODDAMN IT!” I grabbed her by the right arm as I yelled louder and louder. I was out of control.
Thankfully, Janet gently placed her right hand on my left arm and whispered softly, “Larry, it’s gonna be okay. Now, just settle down. I’ll clean this mess up. Why don’t you go in the bedroom and relax? I’ll take care of this.” She picked up little Judy and hugged her. As I walked away, I turned and looked at my wife. Her eyes told me that she wondered if her once calm, gentle, fun-loving husband would ever be the same. For the first time, it was not only clear to me, but to Janet as well, that I was not well and not that same man who left for Abu Ghraib. As usual, the gentle touch of my wife served as my elixir. I calmed down. Janet kept Judy quiet and away from me for a couple of hours. Later in the day, Janet asked, “What was that all about this morning?” I shrugged my shoulders, walked away to the upstairs bathroom, locked the door, and cried my eyes out, thinking about the terrified, hurt look on that innocent child’s face as I was screaming at her like a madman. I got down on my knees and asked God to help me. I begged for his forgiveness. Part of the problem was that I didn’t know the full answer as to why I had unleashed such anger and rage at my three-year-old granddaughter the way I did. She was a child and didn’t deserve it. Or perhaps I was now able to see that I had become emotionally impaired like so many other veterans. I had heard of veterans tearing their houses apart in an unstoppable rage after returning from Iraq, but even as a psychologist I never really understood what prompted such outbursts. Was I just like them?
No! I said to myself, I’m better and stronger than them, and plus, I’m a psychologist. This PTSD stuff can’t happen to me. I gathered myself, went downstairs, and hugged my granddaughter and told her I was sorry. Almost within an instant she smiled and asked me if we were going to go to the beach. Children are so wonderfully forgiving.
Over time, either in person or by phone I would have several conversations with an old friend and senior psychologist from Walter Reed, Dr. Hal Wain. Talking with Hal was always enlightening but it was also healing for me. He helped me work through many of these issues and he never made me feel as though I were mentally ill. He framed what I was going through as a perfectly normal response to abnormal events. I shared my experience at the Starbucks in Kuwait with Dr. Wain. Hal, in his usual brilliant way, helped me to realize that it was the classic psyche struggle.
“Larry, your psyche has figured out a way to reframe the nightmares for you in a healthy way,” he said. “Don’t run from this, Larry. Embrace it.”
He was right. Slowly, over time, I began to return to normal, or so I thought. I busied myself again with teaching, getting back to doing research, and seeing patients. The symptoms of our nation’s new PTSD was in many cases, like mine, very subtle and unlike the old Vietnam veteran stereotypes. Many of us did not disappear from society or turn to alcohol or drugs like the PTSD vet of earlier eras. Janet was the first to see the subtleties of my condition. One evening I was walking downstairs at our home with a cup of coffee in my right hand. Our downstairs is flat with level carpet. Suddenly the coffee cup fell from my hand. A few days later, a bowl of cereal just fell out of my hands. This became common and would occur at least once or twice a week. Whatever I had in my hands would just fall to the floor.
While I was struggling with the lack of muscle coordination in my hands, I started to have trouble with tripping while walking on a level, flat surface without any obstructions. I would be walking down the hallway at my department and I would stumble or trip. The problem would also occur at home. One day Janet and I were loading up in our car, and I went back in the house to get a cup of coffee. While walking across the living room, I stumbled and the coffee cup hit the wall and carpet. Janet came to my rescue, never complaining or patronizing. Again her patience had a curative effect on me.
We loaded in the car and needed to stop by my office on our way to downtown Honolulu for a meeting. By the time we arrived at my office it was after hours and I had left my keys and wallet at home. This was a significant event for Janet. Even though I tried to downplay it, she knew it was a sign of something terribly wrong with her husband. In our thirty years together, I had neither misplaced my keys nor ever lost my wallet. That just wasn’t something I ever did. She said, “No problem, sugar, we can just go back home and get your keys.” Forty-five minutes later we arrived back at our home, but for a long while I couldn’t find my keys or my wallet. On the drive back downtown, Janet spoke up.
“Sugar, I’m really worried about you. You can’t find your keys, your wallet, and you’re stumbling and falling all the time. Larry, what’s going on? You’re yelling and screaming at Judy in a way like I’ve never seen you yell at anybody. I think you ought to go and see our doctor.” Her voice trembled with worry and fear for me as she continued. “You look like shit and you can’t walk around the block once without taking a nap. You used to be able to run four miles a day, do 150 push-ups and 300 crunches without taking a break. Now you’re fatigued all the time. You need to see our doctor because I’m really worried about you.”
I promised her that when I went in to work on Monday I would schedule an appointment with our physician. I never did.
I think I meant to follow through with what I promised Janet, but my worsening symptoms only made me more fearful of admitting to someone else that I had a problem. I got up early on Monday morning as usual for my four-mile run, but I couldn’t finish the run. I was so fatigued after fifteen minutes of running that I had to just stop and walk. Somehow I never found time to go and see my physician. I thought I’d just tighten up my bootstraps and soldier through it, whatever it was. The level of fatigue I was experiencing was like carrying an extra fifty-pound backpack around all day long. I didn’t care. I just drove on. Larry, there’re soldiers coming back from Iraq with one leg who run marathons, I told myself. Don’t be a pussy, Larry. Just soldier through this. Hang on. It will get better.
Either my staff at Tripler Army Medical Center was very patient with me or I was damn good at bluffing my way right through my mental confusion and cognitive lapses. I had worked with many of my staff members for years, but for some strange reason I would lose their names right in the middle of conversations. It was like my mental hard disk drive was crashing. Sometimes it would work and other times it didn’t. Novel information from patients I had very little difficulty handling. But trying to recall old information was troubling, as when I was having a conversation with Dr. Jim Kamona, who had been a psychologist at Tripler for years. Jim came in my office one morning to seek my advice about a research project. Right in the middle of our conversation, I couldn’t recall his name nor could I figure out what in the hell we were talking about. Within an instant, my brain was engulfed in a mental fog. It was as though he had called me at 3 a.m. and asked me to say my Social Security number backwards. I didn’t panic; I just smiled a lot, nodded my head often, and after about fifteen minutes or so, it all came back to me. That became my strategy when I found myself lost in the wilderness like that, and I think most of the time the other person didn’t catch on. They didn’t know, but I was terrified! I thought I was losing my mind.
Janet saw this more and more at home, first by me losing my wallet and keys ten times the first week I was back home. She would just remain calm, never showing her frustration, and wait until the fog lifted. I was horrified by the episodes and scared, for the first time in many years, that the once articulate senior Army psychologist would be lost forever.
Then a weekend would go by without me dropping anything or losing my memory. My symptoms would come and go. The more I thought about it, the more I realized that this was consistent with early-onset Alzheimer’s disease. I was perplexed by all of this. I was not myself at all. But what seemed strange was that I didn’t fit the typical PTSD Vietnam veteran stereotype. I wasn’t having nightmares anymore, I didn’t drink much alcohol at all, and I wasn’t beating my wife. Yet I was clearly feeling the effects of the war. I just wasn’t right, as my wife said more than once.
One Monday morning I turned the TV in my office to CNN. Amazingly, an old colleague of mine from Walter Reed Army Medical Center was doing an interview. Dr. Deb Warden, a noted neurologist and psychiatrist, was talking about how researchers had discovered that some soldiers who had been exposed to blast injuries or extreme stress had abnormal brain scans. Dr. Warden lifted the whole world off my shoulders by explaining my symptoms to me through her CNN interview. I sat there dumbfounded but increasingly relieved as she described every symptom that plagued me: mental confusion, memory loss, rage episodes, and spontaneous stumbling while walking were now commonly seen in some veterans returning from the war. We also now know that the symptoms of soldiers who lose consciousness during a blast explosion get worse, and some never return to who they were before the war. I was lucky—I never lost consciousness. But still, I was one of those veterans who was struggling. I couldn’t hide it anymore.
I went home that night and had a long talk with Janet. She and I were relieved now, glad that at least we knew what was wrong. Dr. Warden’s interview vividly illustrated what happened to a soldier’s brain when he was blown off his feet by a bomb blast—as happened to me several times in Iraq. Dr. Warden explained that the tricky thing is that, like me, even though the soldier doesn’t crack his skull or get shot, the force from the blast still damages the brain. Put this together with the stress placed on the central nervous system from constant psychological strain of being in a combat zone, sleep deprivation, food deprivation, and the 120-degree heat, and the result can be an adverse impact on a soldier’s brain functioning and central nervous system—the new PTSD.
What was happening was that these soldiers were slipping through the cracks of the medical system, just like I did. Why? Well, soldiers like myself were never shot, never hit our heads, nor had any shrapnel from a roadside IED in us. We had two eyes, two ears, a nose, walked okay, and didn’t report any nightmares. The medical system had no reason to pay attention to us. We seemed normal when we returned home and didn’t request any assistance. The only saving grace was that, even when we didn’t seek help, for most of us the prognosis was good. Dr. Warden went on to say that most of these soldiers would return to their predeployment condition. Others—no one knew why—would never be the same.
My struggles grew less as time went on. Just when I thought I had it bad, a new patient, a new soldier walked into my world. I was in my office one day, as usual sipping on a cup of hot coffee and working on an article. My phone rang. It was my secretary. She said, “Colonel, I need your help up front, sir. There is a guy up here who needs some help.” She sounded a little odd. I said yes, that’d I’d come up front, but I didn’t understand why she was calling me with this. “Shouldn’t you be sending him to the psychiatry outpatient clinic or the emergency room?”
“Well sir, yes, I should but this soldier insists on only talking to somebody who is a combat veteran. Sir, most of our providers are civilians.”
I told her I would be right there.
Sergeant Jose Gomez was one horse of a soldier. This twenty-four-year-old specifically requested to see a psychologist who had been deployed to Iraq. Sergeant Gomez was a hard-charging, dedicated career medic. He loved being a soldier. He had a handsome Latin tan that seemed to accentuate his coal black hair and deep brown eyes. From his frame one could clearly see that this soldier dedicated at least two hours per day to the gym, with a purpose.
“What brings you in to see me, soldier?” I asked.
He responded with two words. Two words that symbolized the life, spirit, mind, and body of many soldiers upon their return home. He said, “I’m broken.”
“Son, I’m not sure I completely understand all of what you mean. What’s broken on you?” I asked.
“Sir, it’s not on me,” he said, obviously struggling to explain something that he didn’t fully understand himself. “It’s in me, Colonel. My heart . . . something . . . Sir, my mind, sir . . . My mind ain’t right, Colonel.”
Sergeant Gomez and I spent three hours together that day. He told me about how he had witnessed the carnage in Sadr City, Iraq, the worst ghetto and most dangerous place in that country. He was assigned to an armored cavalry unit. As a medic he was required to go wherever his unit went. The fighting was intense and almost daily for his unit. He saw old men, children, and his buddies get blown apart. And as a medic, he never had the option of turning away and trying to put it out of his mind. His job was to go into the worst of the carnage and try to help.
“Sir, I had to just put all my emotions in a box and not deal with this shit until I got back home,” he explained. “Colonel, I can’t sleep. I hear my dead buddies’ voices all the time. I have to drink three beers just to get to sleep at night, sir. I’m scared.”
Gomez had the more common PTSD-type symptoms. But what brought him in to see me right now?
“Sir, I threatened to choke my wife if she didn’t stop talking. Man, I was out of it this morning, Colonel. I never, ever thought about hitting my wife before.” As he told me this, Sergeant Gomez wept like a child whose mother had just died. I got his family physician to prescribe him medication for sleep and I would work with him in therapy twice a week for the next month and then each week for about six months. Sergeant Gomez got better, stayed with his wife, and rotated on to his next Army duty assignment. There were thousands of soldiers just like him.
My experience with Sergeant Gomez made me think back to a good friend, Colonel Charles Hoge, who had taken a team of researchers from Walter Reed to Iraq to conduct intensive study on the extent of mental health problems among our soldiers deployed to Iraq. I realized that Colonel Hoge and his colleagues had predicted exactly the symptoms that troubled Sergeant Gomez. The colonel and I shared a tent at Camp Victory every Saturday in August and September 2004. Charles and I would doze off to sleep at night while debating. I thought that his numbers overstated the levels of PTSD, depression, and anxiety among the troops. He, in his usually eloquent way, would disagree and say that they most likely underreported the seriousness of the problem. I had to agree now that Sergeant Gomez was neither rare nor unusual. We now know that at least 3 to 15 percent of soldiers and marines have some problems with PTSD, depression, or anxiety when they come home. We also now know that at about ninety days after a guy gets back from Iraq the numbers increase to at least 30 percent. Back at home, the loss of a job, family problems, and grief frequently combine to push many soldiers over the edge. I can’t imagine what it would have been like for me upon my return if I had learned that my wife had left me and/or my home was being foreclosed on.
On many occasions the system gets in our way of helping a soldier get the help that he needs. A reporter by the name of Lisa Chedekel published an article in the Hartford Courant on October 3, 2007, about how many soldiers who committed suicide on their return home from the war had previously been seen by an Army mental health provider. She reported that 43 percent of the soldiers who committed suicide had been prescribed psych medications before and 60 percent were seen by mental health providers before the suicide. A shocking 36 percent had been seen by an Army mental health provider within just thirty days of committing suicide.
Death always finds a soldier, either on the battlefield or at home. That thought kept going through my mind over and over as I reviewed this newspaper article. Chedekel didn’t know that the system gets in the way. Usually these soldiers get lost in the system and commit suicide not because they receive poor treatment by the psychologist or psychiatrist, but because the soldier’s commander won’t listen to them. I wish I had a nickel for every time I said to a commander, “Captain, this guy is not doing well. You need to leave him home,” but then they made my patient deploy anyway. Well, usually they had to send the soldier back early from the deployment. This was a common battle between the mental health department and the manpower demands of the commander’s mission.
On October 19, 2007, USA Today published an article saying that mental illness was the number two complaint among soldiers when they returned home. The numbers are simply staggering. Since 2006 they increased by 20,000, which was about a 70 percent increase over the twelve previous months. According to this article, one out of every seven returning veterans reports a problem with PTSD, depression, or alcohol. Most of the reports just don’t know that these numbers are a gross underestimate. Like me when I returned back from the war, I was not going to say “yes” or “true” to any questions on any medical/mental health screening form. Why? Well, the answer was simple. If I said yes to any questions, that meant that I would be kept at a regional hospital for another month or two, perhaps maybe five or ten months until everything was diagnosed and treated. Soldiers want to go home to their wives, just like I did.
Also, I felt the screening questions to be a violation of my privacy. I did not ask to be evaluated and I wanted to deal with my PTSD symptoms in my own way. As a result of these dynamics, we missed a lot of soldiers like myself. I honestly felt emotionally harmed by the screening process. Just when I would neatly tuck the emotional pain away, some medical general would get an idea to have us screened again. The nightmares returned every time after they forced me to dredge up those memories. Or we would be forced to attend some bullshit seminar on combat battle fatigue taught by an officer who had never deployed anywhere. That was usually an immediate turnoff. Soldiers who have deployed a lot, including myself, find it difficult to take advice or orders from those who have never deployed. On one occasion I was ordered to attend a seminar at Tripler Army Medical Center with two hundred of my closest friends who had all deployed. At Tripler, an Army psychologist who thought he knew it all told us, “You will have nightmares, get drunk a lot, have PTSD, beat your wife, and threaten people.” This enraged me. How dare this ignoramus tell me I’m going to do all those things just because I was in combat?
Given the staggering amount of data documenting the prevalence of mental health problems among the troops, I reflected on my fight with Colonel Kerry Matson when I was down range at Abu Ghraib, trying to convince her that the soldiers at Abu Ghraib needed mental health care on site, not a dangerous convoy trip away. The fact that I even needed to make that argument to her was amazing and awful. I also thought of the warrant officer and interrogator Betty Patterson, who often talked with me about how she had seen two interrogators blown apart by a mortar attack. Her words rang in my ears as I wondered how she was doing, probably home from Iraq by now: “Sir, they died right there in front of my eyes . . . One of their body parts were laying on the ground. I stood there dazed when the medics picked them up and put them in a body bag. After a while, I couldn’t do my work and I just cried a lot. Sir, we didn’t have no psychologists, no chaplains or anybody to help us deal with this. Colonel, sir, it was shameful how they just left us there with no help.”
No human being should have to see that amount of death and feel that amount of pain. I was sent into hell and asked to fix it, I said to myself. Did I? God, I hope I really made a difference.
The global war on terrorism will go on for many years to come. But I was coming to realize that, yes, I had survived, psychologically and physically. And I was beginning to realize that I had made a difference. Many of the positive changes I recommended are still in place at Army detention facilities around the world, and that is one of my proudest achievements.
Another morning found me in my favorite Old Navy pajamas, hot coffee in hand, kicked back in my favorite chair upstairs with the TV tuned to a movie on HBO. I could hear Janet and Judy downstairs, happily making breakfast. Unlike the recent, shameful episode in which I lashed out at my sweet grandchild, this time I was truly relaxed and felt whole again. But still, as I sipped my coffee and enjoyed the quiet of the morning, my thoughts drifted away for a few moments, back to the death ceremony when we loaded the soldier’s flag-draped coffin onto the C-130 cargo plane on the flight line in Kuwait. I could see myself standing there in 130-degree heat, saluting as the honor guard marched by with my fellow soldier’s coffin. I did not know that soldier’s name. All I knew was that this soldier had given his or her life in service to our country, fighting evil on a foreign soil. And this soldier was somebody’s brother, sister, mother, father, son, husband, and America was a better place because of him, his deeds, his dedication to duty for us.
As I heard my granddaughter’s laugh again, I snapped back into the present. I smiled to myself and took comfort in knowing that my rage had faded away, as well as my many hauntings in the night. But then again, the image of the soldier’s coffin being carried on board the C-130 I would always hold on to. I decided to never allow myself to forget this image, my sense of gratitude for those who volunteer for the fight and pay the ultimate price. This image over the years would serve to provide me with a sense of comfort knowing that America has many great men and women willing to make the ultimate sacrifice for its safety, and the fight against evil, tyranny, and terror.
My granddaughter came up the stairs, jumped on my lap, and took a big swig from my coffee cup. I hugged Judy tight and felt a warm satisfaction in this quiet moment with one of God’s sweetest creations.
I look forward to the day when I can sit at Café Du Monde in New Orleans, have a café au lait with Judy, and tell her the story of the great men and women I served with in Iraq, Cuba, and Afghanistan. I want to tell her how I was a part of the fight to help save our humanity.