Authors: Charles Knief
Silversword (38 page)
Chawlie laughed until tears rolled down his cheeks.
“You see the joke?” he asked.
“People died, Chawlie.”
“Gilbert is paying for it. He will be in exile for many years.”
“And that's enough?”
Chawlie looked at me with his little obsidian eyes, his face expressionless. “It will have to be. Better I punish him than anyone else. The world is in balance. I will not lose another son.”
T
he awful dream, my companion for nearly three decades, had come to me again while I was in the hospital. At Tripler, where they had seen their share of battlefield trauma, the night nurse recognized it for what it was and mentioned my experience to the local physician serving with the National Center for Post-Traumatic Stress Disorder. The Center is a network of research sites based at Veterans Administration hospitals around the country, where our nation has deposited many of those who cannot manage to rid themselves of the horrors they experienced. People who are regularly tortured by a sudden reliving of that single, defining moment that changed their lives forever.
he awful dream, my companion for nearly three decades, had come to me again while I was in the hospital. At Tripler, where they had seen their share of battlefield trauma, the night nurse recognized it for what it was and mentioned my experience to the local physician serving with the National Center for Post-Traumatic Stress Disorder. The Center is a network of research sites based at Veterans Administration hospitals around the country, where our nation has deposited many of those who cannot manage to rid themselves of the horrors they experienced. People who are regularly tortured by a sudden reliving of that single, defining moment that changed their lives forever.
People like me.
Dr. Goldman, the PTSD psychiatrist, spent some time with me before I left the hospital and asked me to come back afterward. I had enough to do on the outside making repairs to
Olympia
and getting physically healthy, and was reluctant to return. I wanted to end this thing, but I didn't want to attend a group. I couldn't see myself sitting around a circle of folding chairs sipping coffee from a paper cup and sharing my story with a group of strangers. I also had the vague feeling that my story would be written up somewhere and published in some obscure medical journal. I didn't want to be under a microscope. I didn't want to share my innermost
thoughts and feelings with people I hardly knew. I wanted to lose this nightmare, but there had to be other ways to do it.
Olympia
and getting physically healthy, and was reluctant to return. I wanted to end this thing, but I didn't want to attend a group. I couldn't see myself sitting around a circle of folding chairs sipping coffee from a paper cup and sharing my story with a group of strangers. I also had the vague feeling that my story would be written up somewhere and published in some obscure medical journal. I didn't want to be under a microscope. I didn't want to share my innermost
thoughts and feelings with people I hardly knew. I wanted to lose this nightmare, but there had to be other ways to do it.
Finally, after the dream had come two nights in a row, I called Dr. Goldman and made a private appointment. He agreed to have me come in alone for a private consultation.
“Just to talk,” I said.
He chuckled. “That's mainly what we do here.”
His office was a tiny cubicle at the end of the fifth floor. He had no couch, he said, because he had no room. Metal bookshelves lined two walls, crammed with books. They weren't just stacked, they were stuffed in in all directions, vertically and horizontally, and in no particular order. A small, bright carpet covered the vinyl asbestos tile floor. Dr. Goldman sat at his desk, a battered government-issue model for GS-6 assistants. He offered me a chair next to the desk.
“Be it ever so humble,” he said, smiling.
“You go to ground here,” I said.
His eyes brightened. “You are perceptive, Commander Caine.”
“John. I haven't been Commander in a long time. And it was only Lieutenant Commander, at that.”
“Have it your way. I'm a captain, and I like being a captain. Got the white eagle on my windshield and a good parking spot at the driving range. What more could I want?”
“And in Hawaii, too.”
He nodded. “Would you like some coffee?”
“No thanks.”
“You're still having the dream?”
“More often lately, I didn't have it for years at a time. It was a nuisance, nothing more. Lately it's gotten out of hand.”
“Tell me,” he said, and I did, explaining my life, giving him the short version. He nodded encouragement when I hit the rough spotsâwhen I spoke of Jayne and Kate and Angelâand his eyes widened in disbelief when I explained how I had made my living. I highlighted the shootings, the fights, and the pitched battles in Mexico and Kauai. Coming face to face with monsters had been
the way I had lived. I had sought out the violence. If trouble didn't come looking for me I had gone looking for it. And I had found it, time after time after time.
the way I had lived. I had sought out the violence. If trouble didn't come looking for me I had gone looking for it. And I had found it, time after time after time.
“You've just described to me one of the classic responses to PTSD. Let's discuss that for a moment. Aside from your violent history, you seem to be an intelligent man, and there's no need to be evasive with you. We know the cause of PTSD. It is learned fearfulness. It is the most intense kind of learned fearfulness. Its source can be personal tragedy, a mugging, or a rape, or it can have its genesis in a natural disaster, such as an earthquake or a fire. In your case it was the imminent loss of your life. Let me ask you, you felt helpless at that moment? That precise instant when you awake from your dream?”
“My gun ran dry.”
“And you felt helpless?”
“Impotent was the word.”
“To us psychiatrists, impotent has many meanings, but let's just say unable to respond appropriately. The bayonet was about to enter your flesh and there was nothing you could do about it.”
“Yes.”
“And didâin the actual eventâIt
was
a real event?” He nodded, matching my bobbing head, “didâthe man stab you with the bayonet?”
was
a real event?” He nodded, matching my bobbing head, “didâthe man stab you with the bayonet?”
“Yes.”
“You survived.”
“Of course.”
He smiled. “How?”
“I pulled my knife, a Randall, and killed him. Then I pulled out his blade, reloaded, went back to the business of killing people.”
He thought a moment. “How did that battle end?”
“We had a break in the weather. Fast movers napalmed the perimeter for six hours. At first light we had reinforcements. It was a very close thing.”
He nodded, deep in thought.
“Was that your first time?”
“Yes.”
“And there have been many times after that?”
“Yes.”
He scribbled on his notepad and then looked at me with a kind of compassion I had not seen in a long time. “Sherman said that war is hell. After more than thirty years in this business, I've found that war is pain. Some pain can last a long, long time. You understand, don't you?”
“I do.”
“We have found that PTSD can be accounted for by chemical and physical changes in the limbic circuitry in the brain, the amygdala, the locus ceruleus, the hippocampus and the hypothalamus, extending into the cortex of the brain. After a stress such as the one you described, the limbic system physically changes the way it works. The locus ceruleus is a structure that regulates the brain's secretion of catecholamines, adrenaline and noradrenaline, our fight-or-flight chemicals. One can actually mobilize the body for bursts of super strength, such as you have described in your own life. In PTSD, the limbic system becomes hyperactive. A superabundance of catecholamines is secreted to what would to other people be an ordinary stimulus. A backfire of a car, the popping of a balloon, the smell of rain. Anything that is associated with the experience tends to release this superabundance of chemicals.
“In one study of Vietnam veterans with PTSD, we found that they had forty percent fewer catecholomine-stopping receptors than men without the PTSD symptoms. This suggested to us that their brains had undergone a lasting chemical change. Are you still with me?”
“So far. You're saying that the fright that I had that night on that hill so many years ago changed the structure of my brain?”
“You would make a good student. That is exactly what I am saying.”
“So how does that help me?”
“There are many ways people cope with PTSD. Some become withdrawn from society. There are groups of Vietnam vets living
in the jungles of the Big Island convinced that that is the only way they can live. I see them come in here, when they're ill and need medical attention, dressed in fatigues and tiger stripes. They are unable to get over the war. So they cope by withdrawing from society. There are others who make the leap into chemical salvation: heroin, crack, cocaine, methamphetamines, and alcohol. And then there are those who appear to lead what a politician would describe as normal lives. They just suffer through it. They have their dreams, as you have had your dream, and they flinch and they wail at night, and they divorce and they remarry, always seeking something that they don't understand. But they are not a burden on society in general. To their families, certainly, but they suffer in silence. They were maimed by the war, but some of them didn't even receive a medal.”
in the jungles of the Big Island convinced that that is the only way they can live. I see them come in here, when they're ill and need medical attention, dressed in fatigues and tiger stripes. They are unable to get over the war. So they cope by withdrawing from society. There are others who make the leap into chemical salvation: heroin, crack, cocaine, methamphetamines, and alcohol. And then there are those who appear to lead what a politician would describe as normal lives. They just suffer through it. They have their dreams, as you have had your dream, and they flinch and they wail at night, and they divorce and they remarry, always seeking something that they don't understand. But they are not a burden on society in general. To their families, certainly, but they suffer in silence. They were maimed by the war, but some of them didn't even receive a medal.”
“I have met some like that.”
“We all have, whether we know it or not. And sometimes we read about them in the newspapers. And then there are others, men like you, who spent their lives going after the adrenaline rush. We saw it after World War II and we didn't know what we were seeing. We were not prepared for the Vietnam veterans in the seventies. They had a double burden to overcome. Their father's generation, at least, had won that war. Their war, they perceived, was something to be ashamed of. But that's another issue.”
I could see the flare of anger in his cheeks. “So you're saying that I've got this PTSD. Sounds like a gasoline additive.”
“You may joke, but it's serious. It's not just in your head, it's in the wiring in your head. It's a physical ailment, not just a mental processing one.”
“Someone recently told me that we're just chemicals.”
“That someone was correct. We're learning that more and more. Your body physically craves the adrenaline rush.”
“I used to describe myself as an adrenaline junkie.”
“You were right and didn't know it.”
“Knowing something does not necessarily tell you how to get over it.”
“Your experience on that hill determined the remainder of your life, John. You became addicted to the seeking of those chemicals. Your adaptation to PTSD has been your continued campaigning against what you see as evil in the world. In your narrative to me you described yourself as bad, but not evil. I don't see you as bad. I see you as a good man who deals with his personal demons by attackingâand I mean that quite literallyâthe evil that he sees in the world. And if you can't find it, you go looking for it. That's how you have dealt with the problem. And that's why you continue to suffer from this dream.”
I stared at the clock in the bookshelf, jammed haphazardly between two volumes of
Gray's Anatomy.
I had come seeking answers, but had found answers that I did not expect. If what the good Dr. Goldman was saying was correct, I had not been the master of my fate or the captain of my soul. I had been the mere response to a chemical addiction. John Caine, PTSD, limbic-disordered veteran, attacker of evil; if I can't find it, I'll go looking for it. I could put that on a business card.
Gray's Anatomy.
I had come seeking answers, but had found answers that I did not expect. If what the good Dr. Goldman was saying was correct, I had not been the master of my fate or the captain of my soul. I had been the mere response to a chemical addiction. John Caine, PTSD, limbic-disordered veteran, attacker of evil; if I can't find it, I'll go looking for it. I could put that on a business card.
“So what do I do?”
“Fortunately, medicine has come a long way since the seventies and we now understand that if the brain can be trained to react to certain stimuli, then it can be retrained
not
to react. The body is an amazing organism. It heals itself most of the time. Sometimes it cannot, for whatever reason, and it needs help. People like me are here to help.” He smiled, and I could see the warmth and the tiredness in his eyes. “In PTSD, spontaneous relearning does not occur. We don't know why it doesn't, but it doesn't. You can get over it. But it is going to require your active involvement in the learning process.”
not
to react. The body is an amazing organism. It heals itself most of the time. Sometimes it cannot, for whatever reason, and it needs help. People like me are here to help.” He smiled, and I could see the warmth and the tiredness in his eyes. “In PTSD, spontaneous relearning does not occur. We don't know why it doesn't, but it doesn't. You can get over it. But it is going to require your active involvement in the learning process.”
“What do you want me to do?”
“We've got a group ⦠what?”
“I don't like groups.”
He smiled. “You just said, âWhat can I do?' and the first thing I suggest you tell me you don't like. What is it to be?”
“I'm sorry.”
“We have a group that meets Thursday evenings here in the
hospital. Could you fit that into your schedule? It would help if you heard the others' stories. Just once, at least. You need to know that you're not alone.”
hospital. Could you fit that into your schedule? It would help if you heard the others' stories. Just once, at least. You need to know that you're not alone.”
“Yes.”
“The strong emotional memories that trigger the patterns of thought caused by PTSD can change. It is cortical. You're got to learn how to actively suppress the amygdala's command to react with fear. There are ways we do that, and it is easier if we work with a group of people, rather than one at a time. It has to do with funding.” His smile was weary.
“I'll be there.”
“Fine. Your hour's up. Was up a long time ago, but I thought it was worth the investment of the taxpayers' money. And I had no other patients scheduled, so it worked out. You're a hard man, John Caine, but I think you're worth rescuing.”
“Rescuing for what?”
“We'll get into that. You ever have a lasting and meaningful relationship?”
“No.”
“Well, there's a goal.”
I smiled. “You?”
“Mrs. Goldman and I celebrated our thirtieth wedding anniversary two weeks ago. We are, as Paul Harvey would say, on our way to forever together.”
“Congratulations.”
“Thank you. It's at seven o'clock. Be in the lobby. Someone from mental health will meet you and take you up there.”
“Mental health?”
“What did you expect, OB-GYN?”
I smiled, liking the man. “Thank you.”
“Thank you. If you hadn't been on that particular hill on that particular night, there would be some other fellow sitting here. Or not. I will not debate the evils of that time, or the fact that America sent its young men and women to a faraway land mainly because the President of the United States, a being who picked up dogs by the ears, feared that he would be seen as a man with
small cojones. Seems like a trivial reason to order young men to death and maiming. But that may just be me. I'm a lowly captain of the United States Navy, and I never get to see the Big Picture, you know?”
small cojones. Seems like a trivial reason to order young men to death and maiming. But that may just be me. I'm a lowly captain of the United States Navy, and I never get to see the Big Picture, you know?”
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