Irritable Hearts: A PTSD Love Story (37 page)

I once read a study that found a PTSD rate of 21.6 percent in venomous-snakebite survivors.

“I was born with Hemophilia and those in my generation who have not been wiped out by AIDS or Hepatitis C also have PTSD. Many of the symptoms you describe I and my friends have experienced…” read one e-mail I received. I got another from a man whose wife abused him, which so shamed him that he’d stopped leaving his house, subsequently losing his job and becoming homeless. Another from a man who treated his PTSD with an Oxycontin addiction after his neighbor’s house caught fire and he stood outside of it listening to him call for help while he burned to death. Another from a college student who was raped several times as a ten-year-old boy and wanted to stop spending his freshman year curled in a ball sobbing on Saturday nights while his friends were out having fun.

I meant it when I wondered: Why didn’t the whole world commit suicide en masse?

To put some numbers on the rippling costs of veteran PTSD for the story, I interviewed Charles Marmar, the New York University professor who was on the team of the National Vietnam Veterans Readjustment Study, the most comprehensive study of combat stress ever completed. He was also conducting the new, 10,000-family Iraq and Afghanistan study. The simplest quantifiable story was that the VA was footing $600 million that year for mental health treatment for PTSD vets of Iraq and Afghanistan. Plus $25 million on funding studies. Plus disability checks; if Caleb lived until he was eighty, he alone would cost the VA $1.7 million, not including any of his treatment or prescriptions.

But while those costs of treatment sounded like a lot, Marmar said, it was impossible to spend too much treating PTSD, since the costs of not treating it were so much higher. “Personal tragedy, suicide, depression, alcohol and drug use, terror,” he rattled off. “Stress-related health problems—cardiovascular, immunologic. Heart attacks, stroke, and even dementia. Residential rehab programs and motor vehicle accidents because people with PTSD self-medicate and crash cars; the cost of domestic violence; the cost of children and grandchildren of combat vets witnessing domestic violence. The treatment and compensation disability programs have cost billions. And the costs of the untreated are probably in the tens of billions. Or trillions! They’re enormous.” Police time, court costs, prison time for sick vets who came home to commit soldier-style shoot-’em-ups or plain desperate crimes. Lost wages. Nonprofit assistance, outreach, social services. There were an estimated 100,000 homeless vets on the street on any given night. Veterans made up 1 percent of the United States population, but 20 percent of its suicides.

Regardless, many people acted as if going to therapy were for the wishy-washy and weak. They’d say “He goes to
therapy
” with comically widened or rolling eyes. Despite the money the VA was spending on it, even the VA seemed as if it didn’t take trauma seriously sometimes. “I guess we’re just used to dealing with people with more severe injuries,” a VA nurse had once told Brannan upon seeing Caleb. I had downloaded the VA-developed PTSD Coach app to my phone, hoping that it would offer useful advice. When I tapped it and selected that I was feeling “Sad/Hopeless” off the menu of symptoms, a picture of a blue butterfly popped up. “Distract yourself,” it said. “Word scramble your full name and see how many words you can make out of it!”

My ex-girlfriend who’d been assaulted in that hotel had also been molested as a child. That made her twice as likely to be assaulted as someone who hadn’t, and had left her with textbook unresolved-trauma compulsions and self-sabotaging behaviors that she still struggled with. I couldn’t help wondering if trauma’s multi
-
generation ripple effects had shaped my own past. One of my father’s earliest memories was of standing in a crib while his father drunkenly roughed up my grandmother. And listening to him pound and pound on the door, screaming, when she locked him out. But he said that he’d had no feelings about it. Might it have been harder for my father to dissociate from those bad things he did, if he hadn’t been doing it since he was a baby because my grandfather was a wife-beater?

The only thing that separated the people at my breakfast table in Republic from a lot of people was their openness about their trauma, after years of discussing and managing it. To this crowd, it was the most natural and obvious conversation in the world.

Danna presented me with a brooch she’d made. It was a hand-beaded turtle—she had Native American blood, and it was significant to her heritage—that she gave to the veterans’ wives she helped.

“I’m not a combat spouse,” I said.

“You fight your battles,” she said.

When the food came, the discussion effortlessly switched to Mike’s daughter’s habit of putting peanut butter on her pancakes.

*   *   *

One day, when I’d been sitting on the couch with Brannan, she’d fretted that the picture she was giving me was too bleak. “The whole point of Family of a Vet is trying to give people hope,” she said. “Give people the tools to not give up.” Concerned about how I was going to frame the story, she said, “I don’t want to put out 8,000 words about how hopeless it is.”

“OK,” I’d said. “So what’s your hope?”

“In a perfect world, everyone would know and understand what my family is going through,” she said. “That would make people help, and I’d be less stressed, and the veteran would be less stressed.” In a perfect world, spouses would be prepared, so they could manage both their expectations and their responses to their recovering partners. They would know that the sound of fireworks on the Fourth of July might make for a bad day. They would know that a plane flying too close to their house during Fleet Week might lead to their loved one’s cowering under a table or pinning them to a table by their neck. If people were prepared, they wouldn’t spend the run-up to their veteran’s return counting on Hollywood-style reunions with ecstatic hugging and kissing and days of passionate making-up-for-lost-time sex, then call Brannan saying they were going to leave their veteran husband because he’d come home and locked himself in a closet for a week. Brannan’s coaching sometimes kept families together, and that was rewarding for her to watch.

That night after our dinner, Brannan persuaded Caleb not to leave her. She persuaded him that she still wanted to be married to him. It wasn’t the first time she’d talked him into staying, and she doubted it would be the last. But for the time being, they were still together. That was one example of a hopeful story. She posted as many as she could on her blog, so other people could take heart.

“Two nights ago,” she wrote in one post, “I was doing my normal nightly running around like crazy to get laundry and school bags and lunches ready for the next day, when the hubby found me in the laundry room. To the sound of the running washing machine, the ‘thump, thump, thump’ of tennis shoes in the dryer, and the not so romantic smell of the kitty litter box, he held me for a moment and rocked me back and forth … and we danced. It lasted maybe 30 seconds … a brief moment in the middle of a chaotic day and a difficult week … but a brief moment that I’ve stored in my heart. A light in the darkness.”

“We can reach a deeper love,” Brannan had insisted to me when I was at her house. She didn’t mean just her and Caleb; that “we” included Nico and me. “When you share this sort of thing with a person, and you make it through it, it’s a deeper love, really.” But I remained unconvinced, by her or Danna, that PTSD spouses could always identify and honor the line between being supportive and being subsumed and sacrificing too much.

After breakfast, Nico and I drove back through the Washington wilderness. We were shocked to find that the rooms in our airport hotel, which was attached to a casino, were beautifully appointed and brand-new. The default channel on the TV showed a repeating video about how the Kalispel tribe that owned it had nearly been genocided out of existence by whites but was now a thriving community with prosperous business ventures. The room had a gourmet single-cup coffee machine and a shower with multiple spray jets. It was the end of another assignment leg, completed without going crazy. There’d been less dissociating and weeping, while still staying connected to Nico, my bring-along bodyguard and emotional barometer. It hadn’t been perfect, but I’d done better in Republic than in Alabama. And you know who had hot but loving sex on the Northern Quest Resort and Casino’s 350-thread-count sheets?

Me.

“I don’t just get to see the bad stuff,” Danna had said. “I get to see the good stuff, too.” I mulled various frameworks for including both in the story while Nico and I hung out in the departures lounge the next morning. Someone had left a local newspaper on our seat. It had pictures of all the area soldiers who’d been killed in Iraq and Afghanistan on the front because it was Memorial Day. There was a restaurant-ad sticker to buy any two sandwiches or salads and get the third one free at the top of the page, and it covered some of the guys’ faces. Nico shook his head at America. Were all holidays honoring veterans and presidents here, he asked, celebrated with sales?

We were bored and tired. Nico took to his smartphone as I stared into space. I felt exhausted, given our wake-up time, but normalish. That is: gloomy about reality, but not like I didn’t exist or didn’t want to be alive. I don’t know why I noticed that Nico had been sitting too still for too long, but at some point it seemed like something was off. When I looked over, he was reading an e-mail. It was a long, dense wall of text on his screen. His eyebrows were furrowed, and he started scrolling faster, not reading anymore, toward the end.

“
Non
,” he said.

“
Non
.
Non
.
Non
.
Non
.
Non
,” and as I asked him what was going on, he was standing up and taking a big gasping breath and looked like he’d been kicked in the stomach. It was a suicide note, from his mother.

15.

When Nico’s family members gathered around their kitchen tables to Skype with him at our apartment, they came grave-faced.

In the Spokane airport, I’d thrust Nico my phone, and he’d called his aunt and uncle. They lived near his mother; he told them they had to rush to her house. “I think she would do this with something like medicine,” he said to me, shaky and far-away-sounding, angry, but hoping she’d taken pills so there was some chance she could be taken to a hospital before she died.

She had. And she didn’t, thank God: Eventually she came out of the coma. After her health stabilized, her doctor committed her to a psych hospital. When we got back to San Francisco, Nico was on the phone all day, for days, to France. Talking to the hospital, to his family. Talking, at last, to his mother. I could hear the way his throat closed up when she came on the line. She said he didn’t have to come. She said it in the same way that she’d said in her suicide note that he shouldn’t blame himself and his absence at all. He paced and made more phone calls. He was freaking out and worried and furious and terrified.

I cried to Denise in her office. I made this, somehow, about myself. “I feel like Nico and I must be trauma magnets,” I wailed.

Denise tried to be gentle with me despite my cross of self-pity. But she let it be known that she was not wild about this analysis. “The way you interpret events is very important,” she said. When researchers went back to survey 9/11 survivors about how they felt six weeks later, the results said that “having made sense [of the tragedy] was related to less distress.” Some of the leaders of the field of post-traumatic growth (PTG), a phenomenon that the rosy-cheeked liked to bring up in every conversation about PTSD to remind people not just that it could get better, but that it could end up even better than before the trauma, thought that post-traumatic stress disorder was overdiagnosed and sort of overdramatized. The diagnosis was stigmatizing and victimizing. It did not need to be called an illness or a disease. Some studies suggested that a majority of trauma survivors could experience PTG, and, it was said, many maintained an enhanced spirituality and life appreciation and sense of possibility long after the trauma. The whole ordeal was natural and temporary, and should be viewed as an opportunity for big, optimistic life changes.

Denise didn’t take her philosophy quite this far. Which was good, because while I intellectually agreed with the PTG movement’s message of hope and fighting against stigma, as a crazy person I found it irritating and reductive. I was truly happy that most 9/11 survivors had found increased gratitude just two months later. Elevated levels of hope, and of kindness, leadership, love, spirituality, and teamwork. Excellent for them. But comparatively, I felt like a loser. Denise reminded me sometimes that I’d likely feel better and possibly enhanced later, but there was only so much cheerleading that people in the throes of the worst emotional pain they’d ever experienced could take.

Denise wasn’t letting my negative interpretation of this slide, though. “Can we come up with a new interpretation?” she asked. “One you can really adopt in your body, that will work on a cellular level for you, about your future?”

“We got married,” I told her.

“You
what
?”

*   *   *

We got married.

Because we had already decided to get married, Nico couldn’t leave the country and walk back in with that intent without a fiancé visa, which could take a year to get. If he did leave and come back on his tourist visa, and we got married in the fall as we’d been intending, Citizenship and Immigration Services of the Department of Homeland Security could count entering the country on a tourist visa with that intent as fraud. If we got married immediately, immigration lawyers said, we could apply for an emergency travel permit that would allow him to leave and come back.

While Nico talked on the phone deciding whether to go to France, I was talking on the phone to lawyers.

He decided to go.

And. I.
Hated
. Him.