An Honest Work

A recent trip to Denmark taught me something important about contractors residing and working in combat theaters of operation. You live honest lives. The message came conversely as I watched one person after another in several small Danish coastal villages glide from one day into the next. There are many words used to describe your days, but glide probably is not one of them. And that is where the rubber meets the road in this observation. To engage willingly in a task that by its very nature is both predictable – i.e. DFAC food – and utilitarian demands from contractors a level of honesty almost unheard of anywhere else.

There is not a whole lot of gray in the stark reality of your working life. For example, an honest view of contractor work is there are hardships, which you acknowledge and accept. Relationships are mostly task focused based on an honest appreciation of skill sets, individual capabilities, and trust. Work schedules are fixed and wherein they aren’t sufficient, an honest assessment gets the midnight oil lamp lit and extra hours added into the mix. Acceptance of risks allows for the winnowing out of extraneous non-essential factors, whether they are mission related, personal, or other. Regardless of the relationship with neighboring military personnel, your mindset often replicates the black and white nature of theirs. Again, not so much because you want to but because your honest assessment says it is necessary.

Some of this harsh honesty is an expected part of you work, especially given various remuneration packages. And work for profit is a powerful motivator. That too is an aspect of being honest. Quid pro quo is not a crime. Rather, it is the bedrock of upright and faithful dealing. Honest is as honest does.

I would be remiss (and dishonest) with regard to my own mission if I did not suggest that one additional honest assessment requires our attention…at least from time to time. That being asking the question: Am I different now than when I began?

Why this assessment? Most all of us have a version of the “Danish coastal village” that we hope to return to one day. Using honesty as the best policy, it makes sense to accept one other aspect of combat zones work - the inevitability that it will all wind down one day. And there we’ll be…the most honest person in the room.

Every guy knows one thing for sure. When your loved one starts crying…you lose. Whatever chance you had of making your viewpoint known, or escaping from yet another butt-head move or ill-advised statement that ended when the tears started.

Crying is a mug’s game.

Sure, soft guy in loafers will act like a dime store romance character and weep a bit at the theater when Hollywood pushes the sap button. Kids cry and whine when they fall down. Girls cry all the time for what reason I am not so sure. I swear blind that my baby sister used to practice the act to get her way, but that could just be latent bitterness on my part. My mom, bless her soul, cried when I left for the war zone…every time. And, I have even known some older war veterans who in their last days have succumbed to the temptations to open the spigots over long forgotten memories, dead comrades in arms, and maybe a hint of regret. Like I said…a mug’s game.

The problem is that sometimes we have to play.

It normally starts with a tingle in the upper chest, a catch of breath, and a warm feeling behind the eyeballs. What follows is just plain embarrassing. Crying is very complicated if it befalls you when in the company of others. What I mean by that is that it is pretty bad if you cry in front of your spouse or children. But it is absolutely awful when you play the fool around your mates. Crap! I am pretty sure you cannot ever recover. Trying to pretend there is something in your eye is a weak argument when your chest is heaving and gasping for air. Like I said…horrible.

I cried all by myself the other day. It came on suddenly. This time it was Tom Hank’s fault – the opening scene of “Saving Private Ryan” when he kneels at the graveside of Captain John Miller . There have been others times.

It is funny though, when I am all composed and only slightly self-conscious, I feel more alive. The guys who didn’t come home, the wink-wink-nod-nod at death and suffering, the pessimism, stoic demeanor, and the cold that envelops my emotions takes a brief by noticeable hiatus. I feel better.

Maybe the mug was me and my crying is just another opportunity for me to process through all the complications in my head. I hope so…I don’t mind looking like an ass as long as I am not one.

Turkish Delight is a holiday treat made from starch and sugar, flavored with rosewater and lemon, and an absolute terror on tummy lines. It is also pleasing to the eye, delightfully delicious, and ever so conspiratorially addictive. I think of this treat when remembering the DFAC’s (chow halls) in Iraq and Afghanistan. Bright lights, welcoming windows displaying all sorts of food items, deserts, ice cream, main meals, sandwich lines, special steak and lobster events, salad bars with olives as big as jawbreakers, all the drinks and snacks you can carry. The place resembles a real life cornucopia that I am sure is designed to help relieve us from the pressures of arduous work.

It was always a real joy to enter – with weapon! – the DFAC and get stuck into some eating. Of course, too much “delight” has a cost. Especially if there are stressors in our lives that have the potential to unbalance the delicate system by which we live healthy lives.

Food is a great source of relief besides all the positive social rewards we gain from the activity. In both British and American 21st Century living, eating out is popular as well as convenient and standard for most of us. Even “British tea” had found its niche as a civilized way to share sustenance and conversation. When we are stressed, uncomfortable, working too hard, sick, conflicted on any level, or a combination of all of these the food emporium is a welcome respite.

At issue with the DFAC and all its goodness is that we can – if slightly out of kilter as mentioned above – be over-stimulated by the bright lights and food options. And this over-stimulation can impact how we decide (control) both quantity and type of food we indulge in. As an example, take caloric intake. A nibble here, a dollop there, and a stout main course at one meal, according to recent research, can add up to the total required caloric intake (1350 calories) for the whole day. If we eat two or three more times the math is horrifying. That’s because a single tablespoon of mayonnaise has 100, one hamburger 440, and a small vanilla frosty 155 calories respectively and I haven’t yet started counting the fries.

The second issue is how comfort foods sooth us. And they really work in that capacity. At issue is what has been described as “cortisol toxicity”, when the body for whatever reason begins storing fats and other food attributes under stress as a form of “future defense.” It is preparing for some level of survival – and - might even be assisting us in how we select what foods we eat. It is not uncommon for eating habits to change. Have yours?

One way to find balance (i.e. “rage against the cornucopia?”) is to take back control. Set caloric intake goals. And if necessary, work with a medical nutrition specialist to assist in meeting intake and overall weight and health objectives. When I returned from Iraq I personally lost 26 pounds (12 kilos) by only eating lower calorie foods across the food groups. Never dieted. Never felt hungry. And though I play soccer twice weekly, never hit the gym. What we can learn is how to control the natural urges we get from complicated and often arduous work schedules.

There are virtual medical weight management information that MCA Services would be happy to provide. Remember – MCA Services is a resource for you and your family and supported by donations.

Before you do, consider that there is much at stake. This stuff can prevent hardship that hits DoD Contractors hard…where we live and work. This bulletin seeks to examine WHO you are, WHERE you are and WHAT you are…based on sound research information.

WHO YOU ARE: Individuals who attempt to remain private in spite of living cheek to jowl in close proximity in combat zones worldwide. You are amenable to taking on the challenge of this type of employment. You are focused on that work. You continue in it for good (and often personal) reasons. You recognize that you are part of something greater than yourself. You are fulfilled by freedom and personal autonomy and the opportunity to excel.

WHERE ARE YOU: Admit it, this type of work is not for the faint of heart. Not everyone feels comfortable in a combat zone. Where you are is right in the middle of an industrial society that by its very nature seeks to imprint each member with certain characteristics. In a combat theater of operations, this imprint can have both positive and negative impacts. The good bits tend to nurture personal productivity and performance. The negative impacts tend to retard self-care and may slowly alter the way the brain takes in and reacts to outside stimulation. Note that changes are expected because of where you are. And, that some freedoms and the loss of some autonomy is a fact in any industrial organization.

WHAT YOU ARE: Many combat zone personnel can come off the rails right about here. We all evaluate ourselves, and we are often our own worst secret critics. When the complex arrangements required for success in a combat zone are "sidetracked" – a common event given the fluctuating circumstances –we react. Then, we adjust. And finally, what we become is different over time. When things do NOT go as we planned, or we think we are "swinging in the wind" with respect to our goals and objectives... we take that seriously. Some people panic at this point while others get real quiet. Note: What we are is more often than not determined by what others say we are. A life skill that is vital for good health, welfare and morale is for you to take charge of that process and work hard at accomplishing what is best for you, your success, and your future. Sound obvious? Several recent research articles on our class of contractor rate our potential for traumatic change the highest of all career fields – and – our ability to practice self-care the lowest. What we are might be in danger of change!

PERATO’S 80/20 PRINCIPLE & LIFE THREATENING ACTIONS: 80% of the time things are A-OK. But 20% of the time the crap can hit the fan. In the 20% zone, brain changes noted above can erode a person’s ability to self-protect. We all need to prepare for that 20%! And, be on guard for changes in others. Why? Because the statistics are very clear. People in dynamic circumstances – both before and after - are at risk with respect to suicide. Because of brain changes suicide can become a reasonable option for some. Abnormal? Yes! But if my brain is functioning abnormally, and I encounter difficulty, then life-threatening acts can materialize.

YOU... NOW: You have a reputation for getting things done. Privacy concerns, productivity mandates, focus on results all make “self” and “other” care hard to manage. When there has been a death – or – something like suicide happens in a community, we have learned that the best course of action is to stand down. During this time, reflect on the reality of WHO, WHERE, and WHAT we are. Examine our pressure points. Affirm our commitment to one another. Grive and heal. And frame once again what is vital to us as individuals.

YOU…SUGGESTIONS: (1) Live large when things are going well! (2) Be prepared for the 20% of time when things get tough. (3) Know your confidential resources – vettrauma.org or lifelines.com (4) Invest yourself in your community. (5) Engage your faith traditions if you have them.(6) Learn how to live well.

“Experience is nothing more than the engine that drives adaptation, so it is always important to ask: Adaptation to what? You need to know if your particular experiences has produced the sort of adaptation that will contribute to survival in the particular environment you choose. And when the environment changes, you have to be aware that your own experiences might be inappropriate.” Lawrence Gonzales – “Deep Survival”

Point: Spirituality is one area that is influenced by myriad experiences. Many combat veterans adopt the “no good God” concept, which might even be considered a natural reaction to the horrors of war. Some seeking to survive these trauma(s) – or even be spared the banality of living a joyless and unhappy life – look to spirituality. Gonzales (above) believes that past experience retards our ability to see new perspectives. The changing environment we find ourselves in – aloneness, dissatisfaction with life, need to connect to others – might actually drive us further from spiritual awakening.

Solution: Leave the past behind. Leave old adaptive methods and seek to “survive” by seeing spirituality through a new (transformational) lens.

Suggested Ideas:

€ Look forward not back.
€ Find new ways (lenses) to understand spiritual principles
€ Live spirituality in a new ways

Method: In seeking a new grasp of a meaningful spirituality that will enlighten us, we should consider living – not in the fairways of our lives – but rather on the boundaries. In “Chaos”, James Gleick states that “strange things happen near the boundaries.” In spirituality, strange is a good thing.

Further Discussion Topics:

€ Chaos theory (“Butterfly Effect”)
€ Disorder as a means to spirituality
€ Feelings vs. beliefs
€ Predictable vs. Inexplicable

I went to war as an older person. How old? Old enough to know the difference between real love and lust, searing hate masking jealousy, and petty anger that supplants frustrations and missed opportunities. Oh, and twice as old as everyone else cramming into military transports, sleeping on the cement at BIAP, or trying to hitch a ride on temperamental blackhawks. In a word: ancient!

Ancient people – a.k.a. the experienced and combat zone hardened expert – get to the point when we believe that our age and maturity acts as a buffer to the common reactions and traumas faced by younger people. The “old guys rule” motto is found on T-shirts and hats and in our heads.

In exploring what older people experience when engaged in arduous duty, whether as a military person or a contractor, I found some valuable information about sand piles. A Danish physicist (Per Bak) set up an experiment in the 1980’s that graphically demonstrates, using sand piles, how accidents are part of the maturing process. Bak developed a computer model that replicates sand being added to a pile, much like an hourglass. As the pile grew, it reached a certain height and then began to collapse. The pile didn’t get any shorter, but it didn’t get any higher, either. It was a simple discovery and it tells us much about what we can expect when the sand keeps falling on our heads in placed like Iraq.

What does the sand pile teach us about us? That collapses are an expected part of work and life. As the body of work expands we develop a wider foundation. As we continue to work little collapses (accidents) become the norm. The longer we work, the more accidents we encounter. The more accidents we encounter the more we learn how to survive. And survival means compensation.

Old guys have a gift. We can stand extremes. To handle the demands of arduous living and working, we get very good at rolling with the punches. The problem with this natural reaction to accidents is tolerance. In time, we come not to expect them, believing we have risen above collapses. And that can be our undoing.

Accidents happen…all the time. They are not random, personal, or even arbitrary. Expecting them, knowing that arduous work increases how they impact how we think, work, live and regularly attending to them is the key to longevity. Sand piles in the sand box - how fitting!

**For further reading on this topic, read “Deep Survival” by Lawrence Gonzales and “Complexity” by M. Mitchell Waltrop.

This Veteran’s Day season I had the privilege to be part of five different public observances. I was a speaker at two large universities and two colleges, and sat as a spectator with my two sons at an elementary school in Washington State. Each event made an attempt to represent veterans. Some even succeeded in doing so without waving their proverbial political “Maggie’s drawers”. One speaker started by explaining the difference between Veteran’s Day and Memorial Day, making the point that all of us who survive combat know instinctively: Memorial Day is for heroes. We all know that “heroes” are those who did not return. They are not people who do a job, do something for personal gain, or even complete a difficult task. How can I as a returned veteran compare my experience to the nearly 4000 who have made a supreme sacrifice in Iraq and Afghanistan?

Simply put…we cannot. But we still have a day.

I was surprised to learn that many Vietnam veterans – men and women that we as new combat veterans owe a tremendous debt of gratitude – will go to great lengths to stay away from these observances. In probing this action I further learned that they just do not feel welcome. No doubt, this is the experiential and chemical response ingrained in them as they returned home to an American population divided on the war and her warriors. I sense we, Global War on Terror warriors, are much more fortunate. People care. Organizations reach out. We can get care if we seek it. Vietnam veteran’s fought twice. Once in the jungles of Southeast Asia and again, at home fighting for care and legislation and support favorable to veterans. Their work saved at least one life…mine.

But I digress. Let me get back at the various Veterans’ Day observances and the one that moved me to tears. Sitting through the usual speeches and patriotic songs, the students at Sunnyside Elementary School in Marysville, Washington paused for a moment of silence. I perfunctorily bowed my head. And then the children – some 700 of them – began to sing to the veterans present. Not the shuffling, lumbering, forced singing often heard at school recitals, but loud, emotive, and clear words of praise for all veterans. I was shocked into crying and am sure I embarrassed myself. But it should be noted that these K-5th grade students gave to veterans their all. No holds barred. No discrimination with regard to our type of service, branch, gender, or motivation. Just a resonant multi-voice thank you directed at those who THEY KNOW rate being appreciated.

We might not be heroes. We are, though, veterans. And, we have a day for a lifetime.

I can LIVE with that.

by Joseph Shapiro, NPR

June 27, 2007
Iraq Vet Seeks Out the War's Hidden Wounded

All Things Considered, June 28, 2007 · The first Vet Centers were started almost 30 years ago by Vietnam veterans. The idea was that a veteran with a mental health problem will respond best to another veteran. Today, these storefront mental health clinics are trying to keep up with a new generation of soldiers returning from war.

The Vet Center in Seattle was one of the first to open, in 1979. It runs a therapy session every Tuesday called the Spirituality Group. Men sit in a circle with a Vet Center counselor and talk about how war hardened them and how they struggle now to find the good and joyous things in life.

Lynn Morlan was a 21-year-old Marine lieutenant, leading a platoon during the Tet Offensive in 1968.

"I was in country two days, and my platoon got hit in an ambush. I lost some men and some men wounded," Morlan tells the group. "I knew that day that I was not coming back from Vietnam alive. So I carried that through Vietnam and all of a sudden, miracles of miracles, I came back. I didn't get killed. And then I just continued to live my life that way… I know that death is just right around the corner, just ready to tap me right on the shoulder. So why plan? Why worry about a damn retirement?"

One young veteran in the group, Rob Densmore, sits at the edge of the circle. He flew jets in Afghanistan — the Navy's Prowler, a radar-jamming electronics warplane — but came home in 2004, when he developed life-stopping depression and PTSD.

"I was just unable to make even simple decisions, like if I was hungry or not, " Densmore says.

He's doing better today with help, including group sessions like this one. He prefers coming to the Vet Center because it's a small office suite, with only a half dozen staffers. At Seattle's Veterans Affairs hospital, he feels overwhelmed; it's so big and sprawling that the receptionist at the front desk gives visitors a map and marks their route. And it's hard for Densmore to see so many troubled older veterans, in the lobby and the halls, like ghosts of the future he fears most for himself.

"Just last week, I was at the VA and passed a guy walking down the hall who was a homeless amputee who lives, you know, on the streets below my apartment," Densmore says. "It's a very quick equation to this is who I am, this is my state, this is my lot, and it's not always a good picture that you see on the other side. I get good care at the VA. But you have to be tough sometimes to walk in there and see that."

Welcome Home

It's different at the informal Vet Centers. The first thing you see is a sign above the front door in bold letters that says, "Welcome Home." These signs are a tradition, started because the Vietnam veterans didn't feel welcomed back when they returned from war.

Most Vet Center clients are still Vietnam veterans. Only 17 percent are vets who have returned from Afghanistan and Iraq, but that number is growing. Ron Boxmeyer runs the Seattle Vet Center and says most of the mental health problems are the same — whether the war was Vietnam or Iraq. But there are differences.

"What is really bad about this war is that people are going back three and four times; we had one person who went back five times," Boxmeyer says. "At least in Vietnam, I knew after 12 months I could get the heck out of the Army and I'd never have to go back again. But these people they come home, they go back to work, and re-establish their families and then, bang, they're back again."

There are other differences with the new veterans. There are more women. And more veterans with traumatic brain injuries. These injuries often haven't been diagnosed, but are causing confusion and depression.

Getting Help

Mike Colson is a readjustment counselor at the Vet Center. He was a Navy chaplain in Iraq and Afghanistan, before coming home with his own PTSD. Now he tirelessly counsels troubled veterans and their families. A few Vietnam veterans have brought their sons, recently back from Iraq, into the Vet Center. But Colson also meets clients outside of the center. He regularly catches up with Ole Lindbo at a neighborhood cafe.

Lindbo served at the end of the Vietnam War. The back of his leather jacket reads, "U.S. Army Veteran," and he wears a camouflage skullcap over his long, gray braid. Over coffee, he tells Colson about what he calls "the incident." Several weeks ago, in the family garage, his son Eli, a soldier back from Iraq, started hallucinating that he was under attack.

"He kept saying, 'There's Iraqis around us, they're gonna shoot us. They're gonna shoot us,'" Lindbo says. "For all I know, I could have been an Iraqi to him, and that's why I didn't want to let go of him." Lindbo held onto his son as tightly as he could, as Eli flailed about, lost in a violent flashback.

Therapists at the VA hospital can counsel a veteran. Vet Center therapists can treat their family, too.

Colson helped Eli get immediate treatment at the VA hospital. Since then, Colson and Lindbo meet regularly over coffee.

Last year, a congressional report — and a report from the VA — showed some Vet Centers were struggling to help all the veterans home from Afghanistan and Iraq. Earlier this year, Congress gave funding to open 23 new Vet Centers and hire more staff at the existing 209 centers. But the need keeps growing. More than 1.5 million troops have served in Afghanistan and Iraq, and at least one out of six come home with a potentially serious mental health condition. So far, 51,000 have gone for counseling at a Vet Center.

By Joseph Shapiro

All Things Considered, June 27, 2007 · Many troops returning from Afghanistan and Iraq will struggle with depression and post-traumatic stress disorder. Some will drink too much and use drugs. They'll lose jobs. They'll drive away friends, family, spouses and children. Most of them won't ask for help.

Mike Colson is a mental health counselor for the Department of Veteran's Affairs in Washington state. He believes that with the right medications and counseling, these veterans can learn to live and function while dealing with the mental health problems common to war. His job is to get traumatized veterans into care before it's too late. He jokingly refers to himself as the "dog catcher for trauma."

Colson drives his government-issued car hundreds of miles a day, from military base to military base. He tells scores of men and women just how hard it's likely to be — mentally and emotionally — to go back to civilian life when they have just come from the brutal chaos of war.

At a Navy base near Seattle, 60 sailors and Marines wait inside an auditorium. Before leaving the military, they have to sit through three days of departure briefings filled with information. They're already slumped in their chairs when Colson enters the auditorium, walking with a shadow of a limp. A tough-looking guy, with a shaved head and a dark suit, Colson knows he has one chance to reach the young men and women in the room. He might even save somebody's life.

"To be a warrior, is to be exceptional," Colson tells the group. "But it can come at an emotional cost."

Colson knows there is a stigma attached to asking for help in the military. So he knows he can't use the words "mental illness" or "post-traumatic stress disorder" until he tells them something about himself: He has PTSD.

"Do I look like I have post-traumatic stress?" he says. "Just look at me. What do you think? Why am I able to talk to you? Medicine. That's right, I take it every day. Am I a better person because of it? Yeah. Will I be better next month? I don't know. But I'm better today."

War Experiences Come Home

The Navy sent Colson to Afghanistan twice and Iraq twice as a chaplain. He counseled soldiers who had seen friends die and who struggled with their own nightmares. Colson himself was severely injured in a helicopter crash several years ago. He broke his back and had eight surgeries. When he came home, he was anxious and distant. He put carpet down in his garage and slept there, alone, at night. He was slow to see that these were signs of his own PTSD.

One day, a Navy psychiatrist noticed Colson's "thousand-mile stare" — the distracted and distant gaze that marks those dealing with PTSD.

"He saw it in my face," Colson recalls. "He read trauma like a book… And he saved me. And he medicated me. He took the anger away, he got me to sleep for the first time in a few years."

Now, when he helps others, he is also helping himself heal. But Colson knows recovery is fragile, for himself or anyone with PTSD. And he knows that no matter how many thousands of troops hear him speak, no matter how many he gives his e-mail and phone number to, there will be some he won't reach in time. It has happened in his own family, to his nephew, a Marine who returned home from Fallujah.

His nephew lived far away. Colson called, wrote and even made therapy appointments, but they went ignored. His nephew drank and withdrew. One night, alone in his father's house, his nephew shot himself and died.

In some ways, Colson feels responsible for his death.

"I was a suicide-prevention officer for the Navy, for God's sake," he says. "Let's be honest. I didn't save him. I failed. And that failure will haunt me. When I talk to my sister, it's there. When I walk into a family gathering, it's there."

Stigma Can Cost Lives

He thinks the bravado of military service prevented his nephew from seeking help. He says that in the military, "Readjustment issues, and concerns, and PTSD and that horrible word, you know, mental illness, that's something you never tell anyone and that stigma can cost people their lives."

At another Navy base, Colson gives his speech again. He hopes he will shock more sailors and Marines into getting care. As he speaks, he scans the young faces in the room. He sees a woman with a girlish face in the third row who is blinking back tears. He watches two men who don't laugh at his jokes, but he sees that they're listening — closely. As Colson packs up, the woman in tears and the two men who didn't laugh seek him out privately. Colson will get them appointments at the Vet Center and hope they show up.

When Colson gets to his office the next day, there are four more e-mails from others. It's a handful. But for Mike Colson, it's a start.

After four tours in Afghanistan and Iraq, and having paid the price with significant disabilities, I retired and began working as a trauma and outreach specialist with the Veteran’s Administration. That said, it was obvious that if I were going to visit wounded warriors, I would need help. Enter Quilts of Valor (qovf.org).

When I asked QOV responded. From seeming every corner of the United States, I received quilts from wonderful people that I began taking with me as I visited wounded and traumatized veterans across the great State of Washington. It hurts to admit that I actually became quite attached to these blanket-sized works of art. The mostly men, and some women, who received these in their hospital room and homes were overjoyed – speechless even. On subsequent visits the recipients would invariably ask if others they knew could get a similar blanket. QOV never let them down.

On one occasion, the blanket itself taught me a great lesson. As a provider and clinician, I move through medical facilities constantly. I take into account the standard rules of engagement and, though friendly and engaging, try and keep some distance. On this day my patient was confined to his bed, legs akimbo in stirrups, and bandaged from feet to hips. He had been crushed when two M1A1 tanks crushed the Humvee he was in when executing a failed two-sided pass. The outside of his leg was virtually stripped of flesh. Enter Dr Mike and his quilt.

As I stood talking and commiserating with my charge, the Army sergeant’s dear wife and baby entered. With quilt in hand I attempted to leave the right side of his bed, move to his left, and thereby give the family some room. At the end of the bed I managed to drop the quilt just low enough to catch the stainless steel rod exiting directly out of where his left toe should have been. That’s right; I hooked with the quilt a steel rod sticking out from a man in traction’s toe…with immediate effect! He howled. I howled. The baby started crying and his wife thought we were being filmed for a bad reality show.

The result was two-fold. One, he got his QOV blanket for which they were very thankful. Two, I learned that I needed to get much better at my job fast! The entire family agreed.

To date, I see nearly four hundred soldiers and other military personnel a week conducting trauma outreach for the Seattle, Washington and other Vet Centers. And since that little incident I have not impaled one single quilt loop on a patient or on any of the medical apparatus. So, I am better. But I am not nearly as good as the QOV quilters and staff. I do, though have one piece of advice for QOV’s volunteer; Keep those loops small!

Two guys jumped out of their cars at a local Wal-Mart and started swinging: A man drives by a government car on a busy highway holding a hand lettered sign that says, “F#*K You and the Govment”: A woman shoots and kills a lover outside a downtown apartment complex in an argument over a cigarette: A dog bites man, so man kills dog and all her puppies.

What we have here is a world at war…and I am not a pacifist.

I am not particularly good peacenik. Maybe I should pursue that more stridently but the truth is that I get a kick out of living on the razor’s edge. The medication works wonders. It calms me down even though I still enjoy a good rumble from time to time.

The world is at war…and it impacting people all around me.

Two guys fighting over a parking space at a discount retailer is down right stupid because the lot had plenty of spaces. This wasn’t a competition for resources…just a competition. Two guys who WANT the same thing, even though the thing isn’t worth having.

The man who flashed his sign at me while I was driving the G-car last week would have had better luck mooning me. I was in a good place that day and did not react at all. My little laugh infuriated him. But my “win” was short lived when it was obvious from his crappy old truck, worn look, and poor spelling (he spelled government wrong!), that he didn’t win very often if at all.

Now, shooting your lover over a cigarette is an extreme reaction. The cigs are going to kill one or both of you anyway. Why speed up the process? The facts of the matter will no doubt develop the couple’s poor relationship, abuse, drug and alcohol woes, and a plethora of social and mental challenges. Still, it is a cigarette for God’s sake.

On killing all the puppies…that is just wrong. A mother will protect her litter. She’ll even bite you. Children know this. How is it that a grown man cannot figure out the rules of engagement with one of man’s best friends?

How is it possible? We are a world at war.

This is where I should begin the “let’s all play it forward” lecture. I will not. But, it all has to stop. The bumper sticker that says; “We are killing our friends faster than we can make them”, has a point. The key to peace and recovery is being able to change a course that, for whatever reason, is not working. I learned that as a kid when I learned I culd not hit a curve ball. I switched sports!

God, that would have been a great day if the two burly guys at Wal-Mart had parked their cars in their respective spaces, met on the way into the store, and shook hands. Hell, maybe they’d become friends. My misspelled critic and I could have shared a beer. The deceased lover could have shared his cigarettes and been less an A-hole, thereby preserving a life. And, well, the dog guy…F#*K him.

Dr Mike!

By Dr Mike Colson

Everyone ought to have high points and things to look forward to during the week. Doing interesting things, seeing and spending time with people we like, and maybe even hoisting an adult beverage can all be part of life lived well. I attend each week a single hour session that explores spirituality. I look forward to it because it changes me.

All of the members of the group are volunteers, predominantly Vietnam-era combat veterans, and knowledgeable thinkers. One by-product of the group trying to find joy and peace is that we often experiment with “spiritual recipes.” During our last few conversations we concocted the theory that trauma might be a window – however imperfect – that opens our minds to larger truths shining out of impenetrable darkness. A prime ingredient in this “Light in Darkness” soufflé is trauma…ours.

What is becoming more and more obvious for the group is that the trauma that has marked us appears to have a soft underbelly. Apparently, trauma takes a break from time to time. Imagine a large and foreboding oaf rolling off of you and while doing so exposing rolls of stomach fat. Right then and there you realize the oak isn’t so tough and not nearly as invincible as you thought. You get a gulp of air, you adjust your own body position, and for the first time in a long time you see light. It is not bright or uncompromising light, nor is it startling to the senses. But it is warm…a good indicator that the Spirit has arrived.

Isn’t warmth something we crave?

Oaf or not, I just love to be warm: in my bed, in the sun, snuggled up with a loved one. For dog lovers out there, I also have Jock. He is my large chocolate lab who is typical of his breed – lovable, huggable, and he snores! Just thinking about being warm gives me goose bumps. In the best of all worlds, warmth equals affection.

In contrast, trauma can leave us cold…especially when it’s laying on top of us.

But there is hope; as long as we have the ability to shift, move, jostle, or scrape. In the midst of the struggle – and when the glow appears – take the advantage and look for the spirit. Our group thinks that you’ll see it, feel it, experience and connect with something that “while mysterious and non-physical”, is good.

“The fruits of the spirit are love, joy, peace, patience, kindness, goodness, and self control” – sounds like a prayer request to me.

Dr. Mike Colson

Over the last few years I have become quite used to being a lighting rod for people’s anger. People I haven’t seen in years appear to be triggered by the knowledge of my wartime experiences and forego social pleasantries to launch right into some anti-war, anti-government, or other tirade. For argument sake - and arguments they can become – let’s call this habit “bad talk”.

A few examples of bad talk hurled in my direction – and maybe yours – are:

“Hey, what you think of your government now?”
“Enough soldiers are dead now…when are we going to get out of there?”
“How can we send people to war and neglect them when they return?”
“You were a military guy…what’s up?”

These comments have one thing in common; all inexorably lead me to a dark place where I fight to remain calm and stay composed. But that isn’t the worst of it. As I spiral through one bad conversation after another, I see a pattern began to emerge…bad talk is in reality sad talk.

Sad talk, as I see it, is depressing conversation that people employ when they do not know what to believe. Confusion, media bombardment, death tolls, pictures of suffering, stories of faulty facilities or uncaring bureaucracies can have debilitating and long term effects on individuals and communities at large. The talk is simply a way of speaking out. Bad talk is the result of sad thinking…and I get sad listening to it.

So, what do combat and service veterans do when the sad bug infects conversations? Here is a thought; listen. If we take the time to hear them we might find that the “bad talk sad talk” isn’t personal to us, rather it is a cry for help from them.

We are servants – scarred, skittish, someone afraid ourselves, often angry. But we also have answers because, unlike so many who utter baseless opinions and rhetoric, we’ve been there and done that. We are the experts…so lets help them. And, in so doing we might find our own voice that underscores – with credibility – the value of living a life of importance in uniform and out!

Good Luck.

By Dr Mike Colson

No. 1 Barrier - New age babble and pop psychology: I have spent 22 plus years attempting to provide useful human services to military, combat, and other veterans who find themselves traumatized by the circumstances of their work. Without a doubt the biggest barrier to making the post-trauma transition to good health is poor information. It seems that every person we meet knows more about the problem than the sufferer. In a society where it is tempting to reduce complicated subjects to slogans that fit on bumper stickers (e.g. “Save the Whale”, “Make Love not War”, or “Visualize Whirled Peas”), important information gets left out. For instance, in psycho babble, PTSD sufferers are often referred to as weak, crippled, or somehow unable to cope. You can see how this would be a barrier to getting some assistance?

We do not need to be pitied by the well-meaning or treated like damaged goods. Rather, we need to do everything we can to get the facts about the chemical changes that trauma wreaks on the body, how those changes affect biological processes, and how best to address these physical concerns early with good results.
Solution to well-meaning psycho babble: Get advice from competent medical resources that have experience in treatment and care of the kind of trauma experienced.

No. 2 Barrier – Fear: Men are sensitive about sharing anything from their personal lives, but women are quickly closing the “secrets gap” especially when it comes to harassment, assault, or other sex-based trauma. In my experience stigma and breaches in confidentiality create fear and prevents or delays a trauma sufferer seeking resources for support. Some career types – like police and firemen, security, senior managers, government or other public/community employees DO NOT want anything to interfere with the persona they project on and off the job.

Solution to fear: Find a professional health care provider who has a professional and legal mandate to keep any intervention or information private in accordance with recent HIPAA regulations. And, make sure your records are left in written format and NOT entered into an electronic data base.

No. 3 Barrier – No end in sight: When trauma sufferers begin the process of “stinking thinking” – caused by chemical changes, poor sleep, and even some self-medication (think BEER!) – it can be overwhelming and appear permanent. Of course, it is not and will get better when sufferers take that first step to find helping resources and begin getting up everyday thereafter knowing that life has to and will get better.

Solution to the “No End in Sight” feeling: Call and make an appointment and commit yourself to making your own personal health and well-being a priority.

No. 4 Barrier – Lack of Self-care Priority: Trauma sufferers often puts their own needs behind other people and circumstances they feel responsible for. The New England Journal of Medicine’s recent report on PTSD sufferer’s from Iraq and Afghanistan mark those with the HIGHEST incidence of trauma to be the LEAST likely to seek help. Since January 2005 I have debriefed over 10,000 National Guard and Reserve “War on Terrorism” veterans and this rule holds true across the board. As each goes through the demobilization process, they have a mental list of priorities to complete as they transition home. And, few put themselves and their own personal needs on that list. Why? Many people who get traumatized are in jobs that create trauma – almost like being a sufferer is a self-fulfilling prophecy. As true as that might be, everyone has to care for personal needs. I’ll prove it. Do we share mouthwash, toothpaste, a favorite hat or jacket, or more than a small taste from the 3-taco special meal deal? NO!

Solution to poor self-care: I often use the example of flying on commercial aircraft: “In the unlikely event of cabin depressurization the oxygen masks will drop from the console above and you should quickly place one on all the faces of all the people around you…so they can watch you suffocate.” You’ll say, “Dr. Mike, that is preposterous.” I agree and offer that making self-care a priority, while not often a matter of life and death, is a major factor in living a balanced and fulfilling life.

No. 5 Barrier - Thinking we are crazy or something? Are we crazy? Well, it sure does seem like we are at times. Our blood pressure seems to rise and lower at will, we react to things that in retrospect are very small, we shake, often sleep poorly, develop some poor habits with hygiene, communication, and relationships, and we sometimes drink more than we ought to. So, you wouldn’t blame anyone for thinking that “crazy is as crazy does”. But the point we have to hard wire into our thinking is that the body will react normally to abnormal circumstances. Let me clarify this as best I can. Women and men who serve this country are America’s highest quality youth. To be inducted into military service we undergo health, psych, academic and educational, social, and community examinations. This not only establishes our ability to serve, but also verifies that we are normal – above normal in most cases. But a veteran of war, combat, deployment, and extreme conditions can often be put in some abnormal circumstances. Can anyone really say Iraq, Afghanistan, GWOT operations worldwide and deployments at sea and elsewhere are normal? So, when confronted with these abnormalities – whether they happen to you, others, while you are there, etc – the body will adjust itself (a normal process) in the face of those abnormal experiences. So, on the crazy question…are we? The answer is no. Out bodies are doing what normal bodies do everyday day…but those normal body reactions like those mentioned earlier can and will change you if left examined and untreated. I think we’re crazy when we think the symptoms will all go away by themselves. Vietnam-era veterans taught us that this IS NOT the case.

Solution to crazy: Recognize that feeling like we are turning inside out is normal…and even expected! Accept that these changes are part of the readjustment process and seek out support to understand what your options to make it all go away.

No. 6 Barrier - Failure to sleep well: Everyone needs sound and restful sleep. A major by product of war and deployment for many is a type of sleep that is best described as disorded. In point of fact it more like slumber than sleep. Slumber is not a deep sleep, is not particularly restful, and it does not have all the normal bits and pieces associated with rest. Many veterans drink or medicate themselves to get to sleep, finding that this approach can help in the short term. The problem with sleep – or the lack thereof – is that it is accumulative and can create sever physical – and behavioral – reactions when you constantly get up tired…and angry!

Solution to the Post-War Sleep problem: Find out if you have disordered sleep, pursue getting a referral for a sleep test that might help diagnose a common medical ailment called (sleep apnea) (www.sleepapnea.org). This ailment and other factors associated with symptomatic PTSD and readjustment need to be addressed as a top priority for returning veterans – before it creates long-lasting physical concerns. See your doctor immediately.

Barrier No. 7 – Family: When we return to families and loved ones attempting to fit back into the groove of our former lives, not worrying or scaring anyone about how and what we feel, and even the families needs we find upon return can redirect our energies away from taking care of ourselves. The problem with moving on to other peoples needs – vce our own – limits our access to help and resources – and – can signifucantly reduce our post-wat and deployment life expectancy. A recent New England Journal of Medicine survey found that PTSD sufferes, left untreated, can have their post-military life expectancy reduced by some 50 percent. While family is a priority, it makes sense that you being there for your family is very very important.

Solution to Family – Explain to them what is going one, what steps you are taking to make the readjustment home, find ways they can help you, and bring them on board as your “readjustment assistants.” Family and loved ones are a great source of support, and while they cannot be your medical or readjustment professional, they can help you craft solutions to readjustment on a day-to-day basis.

By Dr Mike Colson

When the blush is off the rose and we find ourselves home at last – whether from deployment, combat, duty in some seeming forgotten corner of the globe, or even stationed on a foreign with an Anthony’s Pizza – it is normal to feel like we are somehow turned inside out. I ask the question when I brief soldiers returning to CONUS; “Are you feeling different these days?” Invariably they answer yes but are somewhat unsure of why they feel this way or that. PTSDresources.org wants to help military members, their families and loved ones understand what has taken place, why we often do feel different, and what can be done once we’ve finally had a few nights sleep in our own bed. So let’s begin by examining issues GWOT veteran’s can expect to engage with as a direct result of their service to this country during this global war on terror.

When we raise our right hand and swear allegiance to the Constitution of the United States, we do so for the very best reasons. As America’s newest war veteran, we stand as a sentinel to faith in our country’s ideals and are prepared to stand in the breach and execute the will of a good government. We may not have run fast enough past the recruiter’s door prior to joining up but we certainly can be classified as America’s high quality youth now that we are in service. And it is important to remember that we, as military servants and military family members, are special people who for whatever reason have a higher than normal does of interest in service above self. That is a good thing! It is also a prime reason why we can become traumatized by that very same service. Think about the 100% you give to serve. If you give 100% to anything, what do you have left over for yourself? The answer is obvious…nothing. GWOT veterans, according to a recent New England Journal of Medicine (http://content.nejm.org/cgi/content/full/351/1/13) who are the most likely to traumatized by their service are the least likely to get some (or any!) kind of support for what can be called symptomatic readjustment /PTSD concerns. In another New England Journal of Medicine article (http://content.nejm.org/cgi/content/full/351/1/75) the psychiatric cost of war is explored, but what is particularly useful about this research is that it points out that the number once reason for not getting support is stigma…being seen to be weak in the face of this new, often misunderstood, and certainly overly dramatized malady…i.e. post-combat and deployment readjustment.

When we get the call-up for war it’s “Hi ho hi ho and off to war we go” and that pretty much holds steady until our hooch mates funk starts burning the hair out of our nostrils! Sure, there is a honeymoon phase when the food doesn’t taste so bad, the water is OK, the mission isn’t too critical, and R & R is easily come by. But when all that good stuff ends and we are forced to life the deployment day and night, then we get to the disillusionment phase. Many get her fairly quickly and dark thoughts peppered with stinking thinking rules. Of course, when we come home we are supposed to start the rebuilding phase and that is when readjustment and symptoms associated with PTSD rear their ugly head. Lack of sleep, excessive vigilance, trembling hands, being startled by noise and crowds, the need for isolation, unexpected anger, fears, inability to sleep or relax, and other factors start degrading our quality of life. Most of us experience this when we get home and the longer we leave it the greater risk we run of it taking root in lives for a good long time. We have been changed and knowing how and why is important.

If you are feeling different these days…you ought to. If you or someone you love and care about has been deployed and served in the Global War on Terrorism, the expectation is that their lives have been radically and dramatically altered as a direct result of their good service. PTSDresources.org is one source – along with many others – that can help you both understand and then get support to “Get Home, All the Way Home” with your hopes, goals, dreams, and family intact.