Thank you for your service


I just got back from a Veterans Day assembly at my kids’ elementary school. The gym was decorated with flags and cute artwork and the program was full of patriotic songs and poems. I was one of approximately 50 veterans representing a total of 360 years of service. The kids were of course adorable and squirmy and they used words like bravery and heroism and strength. Sitting there, watching them recognize the hard work and sacrifice, I couldn’t help but feel pain for a silent war being waged by soldiers, past and present: a war of self-destruction where thousands are dying every year.

I realize that it’s not a popular thing to bring up veteran suicide on a day meant to honor them, but I think the best way to really do that is to be honest about reality for many veterans. If you feel that it is inappropriate, then I ask you to just scroll on past or maybe come back another time. I can only speak from my own experience and don’t claim to represent all veterans. Some of them may disagree with me for bringing this up, and that’s ok.

I recognize that many people don’t know what to say on days like this one, where the spotlight is on veterans.  I get so many quick “thank you for your service” comments. I realize that people may be uncomfortable delving deeper into why so many of us who are veterans dislike that phrase.  It holds the truth at a comfortable arms-length and means we don’t talk about moral injury or invisible wounds or anything else real. It stops the conversation before it even begins.

The latest report statistics for veterans suicide conducted by the VA came out the end of September . The numbers were reported as dropping from 22 a day to 17 per day. If you just read the headlines, that looks still not great but possibly encouraging.  But the fact is that the numbers haven’t decreased, only the way they are calculating them has changed, leaving out active duty, National Guard and reservists from the numbers. This is just a different way of presenting the fact that America is losing veterans at an alarming rate.  From 2007 to 2017, the rate of suicide among veterans jumped almost 50 percent. The numbers have increased steadily over the last four years.

I wasn’t going to write this post, but I feel compelled to bring this up because yesterday  I found out that one of my best friends took his life on Friday. He was one month away from his 20th year of service and the end of his contract. He was a fellow Army medic and he was one of the best.  He was smart and compassionate and he had 8 combat tours. He also fought long and hard against PTSD.  He saved countless lives. A few years ago he got out and worked as a civilian paramedic for a while. But he was lost, and didn’t adjust well to civilian life. We had a lot of long conversations while chugging coffee; about tribe and feeling displaced and restless and what it all meant– the work that we do in emergency medicine, tricks of the trade, and where we put all the stuff we can’t get out of our heads and how we cling to compassion as the last vestige of it being worthwhile. We had shared language and could always be real and honest and yes, at times a little dark in our humor. I can’t believe I will never see him again.

He rarely slept, and he was always in motion. He had nightmares and held it all very close. He ran and biked and rode his motorcycle and tried meds and quitting drinking and  yoga and all the rest but he couldn’t find his way through. He avoided the VA, always saying that was for people with worse issues than him. He didn’t want to take resources from soldiers he thought were “more deserving”. He ended up re-enlisting three years ago and spent most of the last two years in Syria training Kurdish medics. I just talked to him two weeks ago. He sounded tired but not hopeless. We always joked how we were trauma bonded. He was one of the few people I would answer the phone for.  He was there for a lot of the toughest moments of my medical career–many times his eyes were the ones looking into mine across a patient we were trying to save. He was the co-bearer of those experiences and knowing he is gone leaves me untethered and feeling a sadness that is impossible to describe. He was a ginger too and ironically always called me “Red”. He was strong and smart and also broken and I didn’t see it coming. It doesn’t even feel real.

He’s one of those 17 a day now. But so much more than that.  All of these numbers are people. They are brothers and sisters and husbands and wives and mothers and fathers and no matter how the numbers are presented, its clear that whatever we are doing, it isn’t working. The de-briefs we received after deployments were basically a check the box exercise. The unspoken culture is still to stay strong, silent and not let on that we are suffering.  That culture is causing casualties long after the fact.

So on this Veterans Day, maybe check in with your veteran. Be willing to go deeper, beyond what makes you comfortable. Many of us have complex emotions surrounding our time served.  We remember when we were idealistic and service-oriented and struggle to say that while we are grateful for the experience, and feel honored to be among a small percentage of citizens who have served, many of us carry some degree of moral injury as a result of that service. We’ve lost friends and many of our lives have been irrevocably changed by traumatic brain injuries, wounds and PTSD.

Veterans are flawed people who are revered on days like this one, but deep down may feel they can’t live up to being seen as a super hero. It’s a tough burden and can make us feel even more disconnected when we are already struggling.

We live in a time of perpetual war. We have been sustaining a high operational tempo for almost twenty years.  In the early days, the increase in numbers of veteran and active duty suicides got the attention of the Pentagon and many of us were on the receiving end of countless awareness programs and de-briefings. But as time has passed, apart from many incredibly dedicated suicide-prevention organizations, the urgency has faded.  This new report with it’s lower numbers will be seen as an improvement. It’s not.

For some soldiers, the connection to others and the bond even in the worst of conditions is rarely experienced again once they leave the service. It’s a loss of purpose and identity that can be difficult to navigate. And we need to do better in how we support soldiers during times of transition, after deployments or in leaving the military, which is when many of these deaths occur. We need to re-focus on connecting with each other in real life, on a deeper level, not just on social media where it’s easy to put on a brave face. I’m going to continue to try to use my words where and when I can. Because I don’t want to lose any more us.

RIP, G. I will miss you always.


Living Hawthorne

I’m off work today and the sky is grey and rumbly with distant storms. Today was supposed to be one of those super productive Mondays where I superhumanly tackled items on my to-do list before the rest of the week crashes onto me full of ER shifts and doctor’s appointments and tech week for yet another ballet production. But my nine-year-old is home sick today with a fever and a queasy belly after spending all of yesterday, (which was Mother’s Day) looking pale and drawn and not at all his usual self. He’s tucked up in his loft bed reading and dozing and so I find myself drawn to write.  I think I’ve written a hundred blog posts this spring, none of which have found their way into little black letters on a page. My brain has been swirling with ideas and connections but the insistent tug of real life on my elbow has meant that they get shelved for some later time when I can sit down and actually hear myself think.

So today, quite unexpectedly,  I find myself with a quiet house and a steel grey sky that seems to call for coffee and contemplation.  So those thoughts that have been shoved aside are creeping up to me asking shyly “now?”

I think the last time I managed to blog a few months ago I was battling the flu, which turned into pneumonia. My months of training and visualizing myself triumphantly (or wheezingly) completing my first half marathon devolved into a struggle to just walk up a flight of stairs without having to sit down at the top.  My lungs took their time healing, and I found myself weighing whether or not I could possibly run my race, with my longest run before getting sick only being 8 miles and then not running for almost six weeks. It was a bitter disappointment to drop down to the 8k, ( as we all know I hate quitting) but ended up being a good experience as I let go of my expectations and decided to just enjoy the experience of running a race in the nation’s capitol surrounded by history and monuments and about 9000 badass women on a blustery cold day. I stayed with a good friend I’ve made in sobriety, one of the core group of truly amazing women that I check in with daily. As I ran, and watched the sun glinting off the Potomac, surrounded by thousands, I had one of those ridiculous smiling, almost out of body moments where all I could hear was that Talking Heads song playing over and over in my mind: ‘you may ask yourself, “well… how did I get here? Letting the days go by… water flowing underground…once in a lifetime” and cracked myself up at my own cheese and sentiment.  But that’s me in sobriety.

And I think it comes back to the Hawthorne Effect. This is something I had never heard of until a few months back when I saw it mentioned in an obscure NYT article (which my swiss cheese brain has forgotten the name of) and made a note to look it up. The idea of tapping into our own potential just by feeling “seen” intrigued me.  I did a little research and then suddenly I started noticing references to this study. My hospital was undergoing a mock quality review in preparation for a visit by the Joint Commision (hide yo drinks hide yo snacks!)  and someone posted a link about a study that was conducted back in the 20s and 30 at a factory in Hawthorne, a suburb of Chicago.  It had to do with industrial research and I won’t bore you with all the details but basically there was a study conducted which monitored and changed the physical conditions of factory workers after getting their input. While they found that people’s individual performances are influenced by their environments and the people around them as much as their own innate abilities, they ultimately found that workers’ productivity exceeded anyone expectations due to the fact that they were part of a study.  The fact that someone was actually showing an interest in the workers themselves and their conditions led to levels of production no one had anticipated.  Being part of an experiment, where they knew that they were being watched and not in a punitive sense meant that in the end, they did their best work and morale improved exponentially. All it took was an awareness of “positive regard” and something innate took over.  Their best work resulted from the knowledge that they were SEEN. The study called this the Hawthorne Effect. A kind of intangible, unmeasurable magical thing.

So this got me thinking about the last two years of being sober, and how being part of what started as an accountability group has morphed into something I could not have imagined.  Just about two years ago I was newly sober and shakily staring down the barrel of my first “dry” summer with three small children home. I had gotten into a routine of checking in and posting almost daily on a sobriety support group website. I was looking ahead with fear and dread to awkward pool parties and social events and knew that having my kids home and in my orbit was going to make long, leisurely posts and reading sobriety memoirs and time for self-care a serious challenge.  So, I threw out a plea asking for an accountability group that I could text at least daily to keep myself on track. Five women from all over the country answered my call and two years later we are still in touch daily.  We have been through a lot of life changes and trials and challenges as women and mothers, have had the gift of meeting in person, sitting in the same room together, laughing and crying like the dearest of lifelong friends.  We have basically exceeded our wildest expectations as to what could happen when six women who are trying to get sober decide to let themselves be Seen.

We text and share articles and pictures of our kids and video snippets of ourselves telling stories and asking for advice and offering encouragement. We tell jokes.  We lift each other up. We share the profound and the mundane, the painful trials, triumphs and losses.  We think out loud and we grow as we allow ourselves to be vulnerable. You ladies know who you are and I am humbled and profoundly grateful for all you are to me. What an unexpected gift.

Allowing myself to be observed, in the most positive sense (our own Hawthorne effect) has caused me to grow in ways that I would never have done alone.  It’s one thing to live up to your own expectations and another to put yourself out there and allow your life and actions to be observed, and to be reminded what it is we are striving for.  The daily reminders of why are doing this hard, crazy thing (to make our insides match our outsides and to show others it can be done) but not doing it alone have made this journey rich beyond what I could even imagine that first shattered morning when I realized it was time to get sober. I had no idea what was coming.

And so that leads me to the second thing I’ve been mulling over.  Which is Lobsters. I know, random, but hang in with me for a minute.

As I’ve emerged from my winter funk and cast off the lingering shadows of seasonal angst and depression, I’ve found myself saying yes to things that a year ago would have sent me running for the hills.  I’m saying yes to going and hanging out again, traveling with kids, and taking steps to really do things that scare me. Because the discomfort of staying scared and anxious and stilted is just too uncomfortable.  I’ve outgrown my own stories about myself and it’s time to write new ones.  I’m drawing inspiration from a snippet I heard on a Goalcast episode,  and a story told by Rabbi Abraham Twerski.

The transcript:

“The lobster’s a soft mushy animal that lives inside of a rigid shell. That rigid shell does not expand.

Well, how can the lobster grow? Well, as the lobster grows, that shell becomes very confining, and the lobster feels itself under pressure and uncomfortable. It goes under a rock formation to protect itself from predatory fish, casts off the shell, and produces a new one. Well, eventually, that shell becomes very uncomfortable as it grows. Back under the rocks. The lobster repeats this numerous times.

The stimulus for the lobster to be able to grow is that it feels uncomfortable. Now, if lobsters had doctors, they would never grow because as soon as the lobster feels uncomfortable, goes to the doctor, gets a Valium, gets a Percocet, feels fine, never casts off his shell.

I think that we have to realize that times of stress are also times that are signals for growth, and if we use adversity properly, we can grow through adversity.”

So, in doing something that made me incredibly uncomfortable: asking for help and being vulnerable, I have set off a rate of growth that has caused my shell to be tight and restrictive many times over. But because I’m sober and no longer a stunted lobster, I’m casting off the shell.   I’ve come through things that once seemed impossible: quitting drinking, being able to sit in my own skin feeling all the uncomfortable feelings (surprisingly, it’s not fatal!), attending social events as my majestically awkward self, not having to numb my anxiety, navigating death and  losses, running hundreds of miles a year and completing a triathlon after rebuilding a body wrecked by drinking, writing about this experience for myself and others … an entire world has opened to me beyond the narrow confines of self-loathing and hangovers. This winter I have spent my time under the rocks and have emerged in my new shell.   I’m already feeling that this one isn’t going to fit me long. There have been lots of “Ah-ha” moments this spring like the one I had running along the Potomac with an icy wind in my face and tears in my eyes.  I’ll be writing about some of them in the next few weeks.

I’ve got lots of things to sort and examine and I’ve decided it’s time to ask for help again.  I am meeting with a therapist this week. I have low expectations, am keeping an open mind and trying to be non-defensively curious about what comes next for me. That I can even write that, is a testament to the love and patience of sober warriors who have pushed and prodded and listened and borne with me as I slowly figure it all out.

So if you are feeling the pinch, knowing it’s time to level up and be seen, I encourage you to step out and take that risk. Allow your self to be seen by others with positive regard until you can do it for yourself.  Eventually, you will begin to look at yourself that way too, as farfetched as that may sound. I know it’s hard. Hope was something I became afraid of as I reached the limits of my addiction and was trapped in the small and cynical scarred world I had made. It seemed like it was for people who were stronger or maybe just more naive.   I thought I had figured out how to stop being a lobster–numb with alcohol and just not take the risk to ever be soft and vulnerable.  I could stay forever under the rock and attempt to ignore the tightness of my own shell.  My reality was all pain and no hope, so the best I could hope for was to numb out and take some of the pain of life out. I didn’t realize I was taking life out altogether.  I’m not sure I could have said that out loud, but I was certainly living as if that was true.

Now, I say that life is pain, yes.  It hurts like hell some days. But it is also unspeakably beautiful. And the only way to go through all of this is through. It’s frightening but it’s also all real. Transformations aren’t always pretty like we think of when we think of butterflies or other ethereal creatures. I can relate to the lobster– a little feisty and snappy, down in the murk and under the rocks sometimes.  I am soft and mushy inside of a hard shell.  Sometimes I have a literal pea brain.  But I want to get really big.

Because we know the really big ones get thrown back by lobstermen and they become wily survivors who have the best stories.

I want to be one of those.