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.

 

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