South Vietnam (1969)
The research I quote in these blogs is from studies that have resonated with my own experience. I am not a psychologist observing many clients or patients in a clinical setting, but an individual attempting to make sense of a life-changing year in a war zone. The psychological research on trauma is diverse. So are the experiences and backgrounds of war veterans, rape victims, and the survivors of natural disasters. I write from a personal perspective, offering observations from the studies which furthered my understanding.
For many years, a duality in my personality confused me. Once I got past the initial denial that the Vietnam War had any impact on my life, I observed what my rational mind considered contradictory patterns in my postwar personality. I was certainly more troubled, angry and depressed at times, riddled with sleep disorders and bad dreams, and insecure in the world. None of that existed before the war. Simultaneously, my mind had become curious and open to ideas, especially in a philosophical sense. My sense of empathy for the suffering of others changed much about how I viewed the world.
Commenting on his own denial in What It Is Like To Go To War, Karl Marlantes writes:
“I remember, even five years after I got home, laughing with combat veteran friends about all this bullshit about bad dreams and weird behavior as a result of combat. I was just fine.”
Denial is a powerful defense against what we aren’t ready to deal with. The author goes on to state:
“I’d shoved the whole experience deep into my unconscious.”
My starting point for beginning to understand that the Vietnam War had shaped my life in significant ways came through the unconscious. Within three months of returning from the war, I found myself in big trouble with the Army. I thought I must be very stupid—or going crazy. I had coped much better during my tour in Vietnam than I did after my return. With only a few months remaining in the Army, I found myself in the stockade at the Presidio of San Francisco facing serious prison time.
In the stockade, a guard used to come and harass me, tell me I might even be executed. Prison was depressing, but I was coping again. What I hadn’t been able to face was my survivor’s guilt. Assigned to the quadriplegic ward at Letterman’s Army Hospital, my guilt shut me down. The war came rushing back with all the casualties I couldn’t help. I reacted badly to the fake cheerfulness of some of the nurses. They reacted badly to me. My First Sergeant and I clashed. The very fact that I could walk and none of my patients could after returning from the same war consumed me. I hated every authority figure who justified such madness that left wards full of young men paralyzed from the neck down. My worst days in the war were relived in my dreams, the badly mangled and napalmed children. All of it my fault because I couldn’t do anything to prevent or alleviate their suffering.
I finally got in enough trouble that my First Sergeant intervened and restricted me to my quarters, a large barracks with no partitions between the long rows of bunks along each wall. I didn’t give the sergeant or the Army enough time to figure out what to do with me. I packed my few belongings and went AWOL.
To this day, I believe that not all personality transformations from trauma are negative. I always knew that I was fortunate, with the right units, never wounded, surviving the war. There is a hopeless feeling as a medic in not being able to put a casualty back together, prevent a death, take away a person’s pain and fear. It was never about me. I was fully conscious of the fact that every casualty I treated had it worse than I did. This is not some great moral accomplishment on my part showing good character. I think most human beings witnessing the suffering of the dead and wounded come away profoundly changed. It is called empathy.
It is not surprising that medics would experience a deep sense of survivor’s guilt. People who have not witnessed what explosives and automatic weapons do to the human body can only imagine. Serious wounds are horrible—for the casualty, and the medics, nurses and doctors at every level from the field through the evacuation system. It is not just about saving a life. It is about amputations and blindness, paralysis, burns, infections, and pain. Not every wounded body can be put back together. And at the core of every one of them is a human being.
For a broader perspective than mine, Keith Walker’s A Piece of My Heart, compiled the stories of twenty-six women in Vietnam. Mostly nurses, he explores the profound emotions of these women as they treated the wounded in triage units and cared for them on the wards in evacuation hospitals in Vietnam. Their stories include the impact on their postwar lives fifteen and twenty years later.
In Poisoned Jungle, Andy Parks struggles with his survivor’s guilt. It nearly destroys him. Family and friends don’t understand why he can’t simply “get over it” and return to the boy they knew before the war. After three years of trying, he charts a new course and leaves Oklahoma. He doesn’t know what his future will be, but he knows he needs to get away from the expectations of what others expect of him. By now he knows he is transformed by the war. He suspects it might be due to a weakness in his character, but he knows he must get out of Oklahoma to try and sort it out. Even the well-meaning scrutiny has him cornered and his isolation intensifies.
My own view is that it is impossible to witness the destruction and suffering of others without experiencing some degree of empathy. We can never know what our lives would have been without the significant events that influenced us. I can’t help but feel my wartime experiences activated a degree of empathy that was deeper than I would otherwise have developed. That is not a bad thing.
The psychologist, Richard Tedeschi, has spent his career studying this phenomenon. He calls it post traumatic growth, and suspects that half to two-thirds of trauma survivors experience beneficial aspects to their personalities. Let’s explore this in my next blog.