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THE
THING THEY WILL ALWAYS CARRY
-OR-
THE
WHY'S AND WHEREFORE'S OF PTSD
VA Shrink: Were you in Vietnam?
Vietnam Vet: Yes.
VA Shrink: When were you there?
Vietnam vet: Last night.
I’m kneeling. Tears streak my face, drip down, fall to earth.
It’s only my second time in combat. Soon I’ll be different. Soon
revenge for our dead and wounded will meld with fear and I will help
with the killing and the killing will help me. We’re just regular
grunts: We make too much noise, we have no special skills, we’re
not elite. But after a time we get the hang of this war, the rhythm
of it. Wait. Engage. Disengage. We call it contact or movement.
We psych ourselves up. “Time to kick ass and take names,” we say.
And between contact and kicking ass or having our asses kicked there
is tension that starts small, then builds and builds until we
secretly pray it will happen. That we walk into them or them into
us, or we mortar them or they rocket us, then the tension explodes
like perfect sex, and afterwards... we’re spent. There are days,
weeks nothing happens, then terror, instant and deep, then relief,
like paradise, since the killing is done and we have buried away the
wounded and dead. Until it starts all over again.
That was thirty seven years ago. Or was it last night? A
day, a year, twenty years home from war you may begin to act
strange. The shrinks, social workers, group therapists, clinical
researchers, each has a different take on what causes PTSD. “It’s
neurolingustic. It’s cognitive. It’s biochemical,” they chime and
chatter. Who cares? Just stop the pain. Just stop it. But where
does that pain come from? What’s going down? Here is what I know:
What you learn in combat you do not easily forget. You drop at the
first hint of an ambush falling so fast your helmet still spins in
the air. You shoot first and ask questions later. The enemy is an
unfeeling slippery bug to be stomped out. You live like an animal.
You learn to like killing. Learn to fear and hate the enemy. Hate
civilians. Can’t trust the bastards. You hate taking prisoners.
You’d rather kill them. Why? Because the enemy wants to fuck you
up. Kill you, your pals, some new guy doesn’t know jack shit, wants
to waste your Lieutenant, the whole damn platoon.
After a time you learn what war is: the fish like iridescent
gleam inside a brainless head; the sleek white caterpillar of
pulsing human gut; the grotesque tableau of charred bodies frozen
stiff; the impossible music made by voices howling beyond human
form; pure white bones piercing ruby ripped flesh; the strange oily
feel of blood; the sudden slump of the man next to you. The
business of flies on the mouths of the dead.
After a time, to a supernatural degree you learn to live with
terror, rage, struck down sorrow, blocked out guilt or dumb struck
grief. Yes, the supernatural threat of catastrophe and the ways to
survive it become preternaturally normal, second nature, a fully
formed part of you.
Then one day you get shot, or if you are lucky, complete the
tour, return home intact. But for those who have seen their share
the equation might go like this: Johnny got his gun + Johnny marches
home = HEEEREE’S JOHNNNNY!!!!
And the good soldier John or the good troop Jane, who under
fire never once thought of your civil rights, your silly flag, your
doofus politics, Good Johnny or Jane, I say, feel and act a tad
differently when the locked down feelings, bottled up memories,
instinctive behaviors of Post Traumatic Stress Disorder fervently,
unexpectedly kick in. The symptoms of PTSD, in plain bloody
English, are as follows:
Flashbacks: seeing and feeling a combat event as if it were
happening right now.
Hyper vigilance: being always on guard, always looking for
where the next shot, next grenade, next rocket, ambush or IED will
come next.
Survivor guilt: feeling bad, feeling real shitty for having
survived, where other’s in the platoon or squad didn’t.
Moral Guilt: wrestling with actions one did or did not take on
one or more than one occasions.
Startle Reflex: dropping, flinching, turning fast at a sudden
noise or unexpected touch.
Suicidal Ideation: thinking of killing one’s self.
Homicidal Ideation: thinking of killing people. Friends or
complete strangers.
Homicidal Rage: anger way out of proportion to an everyday
event. It comes quick, down and dirty.
Sadness, depression, anxiety, crying spells. Staring into space,
saying nothing.
Nightmares: violent dreams related to combat. Sometimes it’s
the same dream. Some vets make strange noises. Thrash in bed. Wake
up scared, or sweaty.
Ritual Behavior: at night, checking the lights, locking the
doors, maybe keeping a weapon at hand.
Alienation: a vet feels as if no one understands him, doesn’t
fit in, feels as if he or she should have never returned.
Panic Attacks: For a short time the combat vet becomes suddenly
and intensely afraid. He or she sweats, breathe hard, has a pounding
heart, might get dizzy, choke.
Social Isolation: staying alone for long periods of time. Or
in public saying very little. To the point of being noticeably very
quiet.
Drug and alcohol abuse: whatever works to dull the pain glowing
inside one’s head.
Fear of Emotional Intimacy: combats often won’t let anyone get
close to them. If someone gets too close, the vet backs off or
will push them away.
Employment: A lot of vets can’t keep a job. Every couple of
months quit or get fired.
Psychic Numbing: Not have the ability to feel emotions. Vets
talk about feeling hollow, blank, empty.
Denial: Problems? What problem? I don’t have a fuckin’
problem.
High Risk Behavior: Doing daredevil stuff to re-live the rush of
combat.
These symptoms are normal responses to extraordinary events
outside the range of normal human experience. Most civilians are
clueless about combat and its aftermath.
Some types of treatment: The talking cure: a vet talks to a
therapist who is skilled in treating war stress and is not a paid
bull shitter. Group therapy: seven to ten vets meet once a week for
an hour or two. A good group leader is essential. That person knows
when to talk, when to listen, how to keep the vets focused.
Otherwise group therapy can get lame fast. EMDR: a form of hypnosis
in which the vet is fully awake. Exercise. Meditation. Meds. A
friend who will just listen. An artistic endeavor. One other
thing. This is real important: A lot of vets fear talking about
war. They fear losing control. Breaking down. Crying. My advice to
those who have seen combat: face yourself. Chances are good you
will learn to live less in the past, more in the present, but you
will never be the same. WWII, Korea, Panama, Vietnam, Iraq,
Afghanistan, Central America, wherever you were, whatever you did in
war will always be with you. Always.
Originally published
in CounterPunch July 24 2006
Marc Levy served with Delta Company 1/7 First
Cavalry as an infantry medic in Vietnam and Cambodia in 1970. His
decorations include the Combat Medic Badge, Silver Star, two Bronze
Stars for Valor, Air Medal, Army Commendation Medal. He was
court-martialed twice and received a General Discharge.
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