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Moral Injury: The Silent Killer of Veterans

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This morning I woke up and got ready to go to work. My wife was up. She had been up most of the night because unbeknownst to me I had been fighting something in my sleep. Judy tried to wake me up, but I didn’t wake up, and evidently the episode lasted much of the night. I do remember some dreams, or rather nightmares last night dealing with a particular situation that I experienced in Iraq, but such nightmares are so common that unless there is something really unusual about them I really don’t think much about them.

I first heard of Moral Injury in 2009 about a year after I was diagnosed with severe and chronic PTSD. However, that being said as a military historian I have to admit that I have read about it time and time again in less clinical language. What I had more experience with were the memoirs of common soldiers and officers, as well as the experiences of Sailors, Marines and Soldiers who had confided in me at various times as their chaplain.

Marine Major General and two time Medal of Honor recipient Smedley Butler wrote in his book War is a Racket:

“Boys with a normal viewpoint were taken out of the fields and offices and factories and classrooms and put into the ranks. They were remolded; they were made over; they were made to “about face”; to regard murder as the order of the day. They were put shoulder to shoulder and through mass psychology, they were entirely changed. We used them for a couple of years and trained them to think of nothing but killing and being killed.

The suddenly, we discharged them and told them to make another “about face”! This time they had to do their own readjusting, sans mass psychology, sans officers’ aid and advice, sans nation-wide propaganda. We didn’t need them anymore. So we scattered them about without any “three minute” or “Liberty Loan” speeches or parades.”

Last year I was interviewed by David Wood of the Huffington Post for a series of three articles that he just published on moral injury.* If PTSD and TBI are considered “invisible wounds” then moral injury must be included. It is a condition as old as war itself and can be seen even in the most ancient of writings about war, Homer’s Iliad, King David’s grief over the loss of his friend Jonathan and many others.

I came home from Iraq forever changed. I served with Marine and Army advisers to Iraqi Army, Border Troops, Police, Highway Patrol and Port of Entry Police in Al Anbar Province in 2007 and 2008. That assignment, which took me throughout the province brought me into contact with a part of the war that many Americans, even those serving in Iraq were shielded from, a part of the war that was never shown in the media that exposed me to realities that before serving there I was unaware.

They were uncomfortable truths. The tensions between the various Iraqi factions, the real hopes for a better Iraq held by many Iraqis and the absolute devastation that the American invasion of Iraq had brought to that unfortunate country. I saw some of the disrespectful and insulting things done by American troops that had to be dealt with by the advisors, men who were as much diplomats as they were Soldiers and Marines. I saw the damage inflicted by bombing campaigns that had little to do with winning a war, but more with destroying infrastructure that even our own war plans had determined was vital to Iraq’s recovery after the success of our campaign. I saw children wounded in fire fights, as well as ministered to the wounded coming through the Fleet Surgical Facility at Ta’Qaddum on their way elsewhere.

I have spent time with Marines and Soldiers who feel real guilt from the actions that they saw or participated in both in Iraq and Afghanistan. Likewise I have dealt with the grief of men and women, Corpsmen, Doctors and Nurses who wish that they could have done more to save the lives of others or done more to prevent suffering. I have also dealt with those who have attempted suicide after taking part in actions that they could not live with or due to what they saw or experienced in Iraq or Afghanistan.

Unfortunately Moral Injury is not taken seriously by the military. This despite the fact many military physicians, mental health providers and chaplains are on the cutting edge of dealing with it. We are doing research, writing and treating those afflicted the services themselves do not even acknowledge it. Even as we do this some in the military, including Chaplains want to call it something more ambiguous using the Orwellian term “inner conflict” to describe something that is far more damaging and insidious.

I suppose that a big part of the reason is that all of the services do an amazing amount of work to built a set of moral values in those that serve. In the Navy we talk about courage, honor and commitment. We talk about being men and women of principle, doing what is right. Such ideas are a part of who we are, Douglas MacArthur spoke of “Duty, Honor Country” and our military academies have long taught the principle that “I will not lie, cheat or steal, or tolerate those that do.”

We teach our Soldiers, Marines, Sailors and Airmen values that are often more rigorous than what they grew up with at home or in school. Then we send them to war and they see and sometimes do things that are at odds with those values as well as the values that we as Americans cherish. We place them in situations where the moral values we teach them contradicted by what we teach and train them to do, and the real unvarnished truth about war, it is hell. Smedley Butler wrote:

“But the soldier pays the biggest part of this bill.
If you don’t believe this, visit the American cemeteries on the battlefields abroad. Or visit  any of the veterans’ hospitals in the United States….I have visited eighteen government hospitals for veterans. In them are about 50,000 destroyed men- men who were the pick of the nation eighteen years ago. The very able chief surgeon at the government hospital in Milwaukee, where there are 3,800 of the living dead, told me that mortality among veterans is three times as great as among those who stayed home.”

How we expect anyone to retain their soul and their sanity when we teach them a set of values that we as a nation fail to uphold is beyond me. The fact that the politicians, pundits and preachers who constantly insist on using the under one percent of the population that serves in the military to bear such burdens to satiate their bloodlust and then refuse to recognize their injuries and then deny them care or benefits is abhorrent.

One of the survivors of the famed World War One “Lost Battalion” wrote:

“We just do not have the control we should have. I went through without a visible wound, but have spent many months in hospitals and dollars for medical treatment as a result of those terrible experiences.”

While I was impacted very much by what happened to me and what I saw. The sad thing is that I was far better prepared and seasoned to survive what I experienced than most of my younger counterparts. After years of training and experience I felt that I was immune to PTSD or Moral Injury. Sadly, I was wrong and today, more than six years after I returned from Iraq I deal with the consequences of war, in my life and those of those that I serve.

I don’t pretend to have answers, but I do expect that our country takes responsibility for the injuries and suffering that its policies have created. Specifically I am speaking to that Trinity of Evil, the Politicians, Pundits and Preachers who constantly lobby for war and refuse to take personal responsibility for it when it comes, and who then for matters of political expediency throw aside the volunteers who went to war for far higher ideals and motives than those that sent them.

Okay, it is time for me to take a deep breath. But I do get really spun up about this, because I have lived this reality and I get angry when I see look around and realize that for most people in this country, the plight of veterans doesn’t matter. We are just another “special interest group” to use the words of a member of a committee appointed by former Secretary of Defense Donald Rumsfeld that wants to decimate military benefits. But even now people like Bill Kristol who have never served a day in the military and never seen a war that they didn’t like, urge that we send more men and women to war over Crimea. But I digress…

Moral injury is a silent killer of the soul and it is high time that we recognize just how deadly it is.

Guy Sager, author of the classic The Forgotten Soldier wrote: “Only happy people have nightmares, from overeating. For those who live a nightmare reality, sleep is a black hole, lost in time, like death.”

I don’t know what nightmares I will have tonight, hopefully at least for Judy’s sake I won’t have any.

With that, I will sign off for the night.

Peace

Padre Steve+

Wood’s Articles can be found here: http://projects.huffingtonpost.com/moral-injury/the-grunts
http://projects.huffingtonpost.com/moral-injury/the-recruits
http://projects.huffingtonpost.com/moral-injury/healing

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Filed under iraq,afghanistan, Military, PTSD

A Matter of Honor: Padre Steve Defends the Navy in Firing Captain Owen Honors

Captain Owen Honors

Note: I am a career Naval Officer with a further 17 ½ years service in the Army. I have served at sea, ashore, in combat and commanded an Army Medical Company during the Cold War. I have had the honor of serving with many fine Naval Officers as well as Marine and Army Officers as well as Navy Chief Petty Officers and Army and Marine Corps Senior Non-Commissioned Officers. I write this essay due to the numbers of people on Facebook and other sites defending the actions of Captain Honors. My comments and opinions are my own but I believe are in keeping with Naval Regulations concerning the treatment of sailors and the UCMJ and reflective of the Navy’s Core Values of Courage, Honor and Commitment.

Captain Owen Honors was on the fast track to becoming an Admiral. He had an accomplished career in Naval Aviation including command of the “Checkmates” of VF-211 and the Flagship of the 6th Fleet USS Mount Whitney which he commanded during the Russian invasion of the Republic of Georgia.  As an aviator he flew over 70 combat missions in three theaters. His downfall came as a result of his actions as the Executive officer of the ship that he was preparing to deploy the USS Enterprise CVN 65.

I am not going to regurgitate the story of his firing other than to say that his actions have created a mini-Tailhook scandal that will be with the Navy for the next 6 months to year. Captain Honors’ supporters on his Facebook support page have attributed his firing to “political correctness” and even linked it to the repeal of Don’t Ask Don’t Tell.”  The excuses made by many of his supporters which include a number of men and women that served on Enterprise play down the significance of the videos, of which we have seen but a few edited versions.  The defenders of Captain Honors are for the most part very profane and vicious in their criticism of the Navy and launch some pretty raunchy and mean spirited attacks on those that defend the Navy or criticize the actions of Captain Honors.

Some in the alternative “conservative media” over at “Accuracy in Media” is all over this linking it to political correctness, don’t ask don’t tell or an intentional effort of the media plot to convict Captain Honors and disparage the Navy.  Of course they ignore the fact that they probably wouldn’t want their daughters to serve under such conditions.  In fact to me it looks like they are making this an issue because of the repeal of Don’t Ask Don’t Tell. These are the same people that criticize television shows such as Family Guy, Jersey Shore and other shows which supporters of Captain Honors have compared to his video productions.

However the videos are the tip of the iceberg. Captain Honors responded to critics in one of the videos calling them gutless. Reportedly there were people on the Enterprise that tried to warn the command about the videos that were brushed off.  This tells me that while he had many supporters that there were a fair number of people who were concerned but feared retribution if they reported the incidents to the chain of command, spoke up too loud or went outside the chain of command such as to the IG or their Congressmen.  From what I see Captain Honors showed a callous disregard for good order and discipline on the Enterprise and helped foster a climate in which those that had been sexually harassed discriminated against or were offended by the videos for whatever reason did not feel safe in approaching him.  The Executive Officer of a Naval Ship has tremendous power. Most efficiency reports are routed through him before they get to the Captain and all disciplinary cases go through him before they go the Commanding Officer and in most of those matters he can either dismiss charges or refer them to the C.O. for adjudication at Captain’s Mast. In effect almost everything on the ship stovepipes with the XO who along with the Command Master Chief are the men that set the tone for morale on such a large ship where much of the crew, unlike the crews of Cruisers and Destroyers have little contact with the Captain. Believe me as someone who served under excellent CO’s and XO’s at sea and ashore Captain Honors and behavior in “producing” these videos was poor leadership. While many may have found them humorous the XO’s job is not to produce videos but to set an example for all his sailors.  Since almost all ships have satellite television or TVDTS (TV Direct to Sailors) as well as internet access, educational programs, religious programs and a host of Morale Welfare and Support activities to cater to a wide variety of interests I have a hard time with the excuses made for his actions by his defenders.  The ship’s internal television or SITE TV is used on most ships for either movies or public service type announcements; it seems to me that Captain Honors abused that system as well as the sailors that maintain it.  Those on the Facebook page and other sites that claim that the videos were “necessary” to relieve tension from the deployment are either very misinformed or don’t really think much of other people. Add to the fact that liberty during port-calls is another “stress reliever” leads me to believe that the videos were made not for stress relief of the crew but for that of Captain Honors.

Men and women selected as XO’s and CO’s of ships are hand-picked and attend XO and CO courses before they assume the job. In those courses they get the policy of what is and is not tolerated. These are not stupid people, they understand the rules and the fact that Captain Honors produced and showed these and continued to produce and show them after somebody complained to him demonstrates to me that he believed that he was above the law.  Yet his supporters act like this is no big deal. I wonder if the supporters had a child, especially a daughter serving in such an environment if they would be so protective of such a commander.

The Navy’s investigation is just beginning and it will be painstaking thorough.  I am sure that a sizable number of people that knew about these videos and did nothing despite complaints of some crew members from the senior leadership of the ship to the Carrier Group Staff and Air Wing Staff will investigated.  Likewise the Navy will investigate the climate of command during that time period and will look a military discipline, equal opportunity complaints, sexual harassment and assaults, rates of suicide attempts and gestures and a host of other indicators of the climate of command on Enterprise when Captain Honors was the Executive Officer.

This will be somewhat like Tailhook or the Army’s Aberdeen scandal. It will not be pretty; careers will end because leaders failed to do the right thing when this occurred. What is it that they say; an ounce of prevention is worth a pound of cure? Had leaders acted when this occurred then there would be no scandal now. Because of the actions of Captain Owen and his enablers the Navy and all of us that serve have to endure the aftermath.

Captain Honors’ actions may have been blatantly wrong but those that knew on the closed community of the Enterprise on deployment and had the power to put an end to it then are even more responsible. Captain Honors was the Executive Officer which means that the Commanding Officer as well as the embarked Carrier Group staff should have shut this down to protect the life and career of a promising officer.  They are just as responsible and I am sure that when the investigation is completed that all who could have stopped this will be disciplined. This is not political corrected gone mad it is how military professionals conduct matters of honor.  Navy Officers are held to a higher standard, the lives of our sailors depend on that and the country counts on it.  When we fail we betray the trust of our sailors, their families and the country. To quote Admiral James Harvey of Fleet Forces Command:

“It is fact that as naval officers we are held to a higher standard. Those in command must exemplify the Navy’s core values of honor, courage and commitment which we expect our Sailors to follow. Our leaders must be above reproach and our Sailors deserve nothing less,”

Peace

Padre Steve+

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Filed under Loose thoughts and musings