Tag Archives: naval hospital camp lejuene

July 30, 2014 · 21:18

Broken and Unlikely to Get Better: Military Mental Health Care

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Well, my friends it’s time for me to get on the PTSD soapbox and go “Smedley” on the military mental health system. The fact is the system is broken, maybe not as bad as the VA, but broken nonetheless. The biggest part of the problem is not that there are not enough providers, there are not even though many more have been hired. The biggest part of the problem is that the system has lost any humanity that it once had, all in the name of efficiency and the budgetary bottom line. The fact is that the bottom line actually matters more than people and bean counters, not providers have the final say.

Marine Corps Major General, and two time Medal of Honor winner, Smedley Butler wrote after he retired in his classic book War is a Racket:

“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.” 

Two years ago, the Navy seeing a increase in healthcare costs decided to bring as many people back into the Navy Medicine system as possible and cut back on referrals for active duty personnel. I understand that, money is short and Lord knows we need to save it wherever we can in order to buy aircraft like those in the grossly over-budget, behind schedule and substandard F-35 Lightening stealth fighter plane program, or ships like the Littoral Combat Ship which are over budget, under armed and not designed to survive the slightest combat. Mind you, none of the F-35s are in service, despite a decade of tests and production delays, costing hundreds of billions of dollars. But I digress…after all, war is a racket.

Now let me be honest and as fair as possible. There are many great mental health providers in the military and the Navy Medicine system; active duty, reserve, civilian and contractors. These people actually do care, but often they don’t get to make decisions that they think are right for their patients. At the same time there are others working in the system that are just in it for job security or the money. However, all of them are at the mercy of commanding officers that decide how they want to spend their budget, and dictate to their providers, sometimes at the threat of their job, contract renewal, a positive fitness report or promotion recommendation what they will approve, or more likely, deny. Thus in some cases commanders will support their providers doing whatever possible to get patients help, while others look at the bottom line. I have had both experiences.

I have been getting mental health treatment for PTSD since July 2008 when my life fell apart after Iraq. I have had mental health providers in the Navy Medical system. I also had a civilian psychiatrist who I was allowed to see when I was at Camp LeJeune, even after Navy Medicine decided to bring people back into the Navy Medicine system.

You see at Camp LeJeune, the old hospital commander, who I worked for, and the Director of Mental Health who I worked with realized that as a Chaplain that my personal and professional privacy, and my need for continuity of care was important. They realized that I needed to feel safe. There I was treated with professional courtesy, with humanity and I felt like people actually cared about me. That was was something that I needed then, and still need now. Unfortunately that is not happening now.

When I returned to the Hampton Roads area I knew that I still needed mental health care. I finally got my first visit and intake evaluation in June. My first appointment with a psychiatrist came on July 7th. The psychiatrist herself was not the issue. You see I used to work at the Naval Medical Center for two years and continued to work at the Naval Hospital Camp LeJeune for another three. I am fairly well known in the Navy Medical Region East.

I suffer a tremendous amount of anxiety. I admit it, I am still bat-shit crazy. I have the PTSD “Mad Cow.” The night before my first appointment I could not sleep, most likely because of being anxious about going to the Naval Medical Center outpatient mental health clinic. The fact is, it is really big and impersonal, and frankly that scares the hell out of me. I can’t go to big churches for the same reason. I feel terribly unsafe in them.

My worst fears were borne out. The waiting room was crowded, and after waiting I had my name and rank called out for everyone to hear, so much for the expectation of privacy, in fact I think that was a HIPPA violation. In the intake room I was met by three very junior hospital corpsmen. I didn’t even get a “hello, how are you doing sir?” from them. Instead one told me to take off my shirt, one told me to step on a scale and after that I was told to sit down, and got my blood pressure taken. My blood pressure was twenty points, actually almost 30 points higher than normal, even after I have just had a bunch of caffeine, which I did not on July 7th. I have to attribute the rise in blood pressure to the anxiety of just going in to the clinic, there is no other reason. After I had my vitals checked, I was asked a series of rapid fire questions that were very personal in nature and that I would prefer a doctor or nurse ask. I was then told to go back and wait.

The whole process was impersonal, embarrassing and dehumanizing. But it was very efficient, and the bean counters should be happy. That being said it was the absolute worst experience I have had with military medicine, and that includes having a thumb stuck up my ass and having to duck walk at the Military Entrance Processing Station. That was a rite of passage, but this scared the absolute hell out of me, I did not feel like I mattered as a person to anyone in the clinic.

When I saw the doctor she was pleasant. I told her of my experience and requested that I be referred to a provider in town as I had at Camp LeJeune. I was told that she would submit the request to her division officer who is a doctor that I know, and get back to me in a day or two. I didn’t hear from her. I waited two and a half weeks, and finally decided to e-mail the doctor on July 24th asking what was going on. Today I got an e-mail telling me that “my case could not be sent to the civilian network.” No reason was provided. The time between that appointment and the denial of my request was almost four weeks, totally unacceptable by any standard of care, military, civilian or even Klingon.

I was given the option of seeing a provider at an outlying clinic however the one close to where I work would be similar to the main hospital, crowded and impersonal. The other option was using a resource called “Military One Source” where I could get up to 10 or 12 appointments with a civilian provider in town with no guarantee that I would be able to see them after those visits were up without approval from the same people who just told me that I couldn’t be seen in town. If I do that my medication would then be managed by my PCM instead of a shrink. At this point I no longer have any trust in the military mental health system, at least for me, and the Military One Source providers are not really there to deal with long term chronic conditions.

I knew that I was being blown off. In military speak it is the old adage that “a mission passed is a mission completed.” The fact is that I do not matter to these providers. Unlike the people at Camp LeJeune, they have no personal investment in me as a patient or as a professional colleague, so why should it matter to them? I don’t write their evaluations, the bean counting admiral does so, why would an old and broken chaplain who doesn’t work with them matter?

Likewise I am being treated like a child in regard to medication. I have no history of drug abuse, prescription or otherwise. Unlike LeJeune where my doctor put refills on my as needed PRN anxiety medicine, I now have to subject myself to the industrial “production line” inhumanity of that clinic, just to get a refill each month.  Even if I didn’t want therapy I would have to endure the ignominy of the inhuman treatment at the clinic 12 times a year just to get a pittance of very low dose anti-anxeity medication. I don’t need that kind of abuse, and that it exactly what it is no matter what the bean counting admiral calls it.

But here’s the deal. I am a senior officer. No wonder so many senior officers decline treatment, attempt to hide their symptoms and self-medicate. The treatment in the system is demeaning and the stigma is there. I have known of a good number of senior officers, Marines, Navy and Army who have ended up losing their careers or lives over untreated PTSD. Right now I am debating even if I should go back to therapy. I know I need it, but if it is a choice of the abuse I am going through at the mental health clinic or maintaining a semblance of human dignity, a good craft beer tastes far better than Xanax.

Not only that, but an even far more important reason than me and my needs, that of the junior enlisted personnel who seek help or are directed by their commands to get help from mental health. Now I cannot imagine what it would be to be a powerless junior enlisted soldier, sailor, Marine or airman. But wait I can, I enlisted in the National Guard back in 1981. However, back then I wasn’t broken, and I cannot now imagine what is is for young, powerless enlisted personnel have to go through what I am going through when getting mental health treatment. That is the bigger issue.

Is it any wonder that the military suicide rates are still high and that this year the Navy is up from the same time as last year? According to statistics released last week, there have been 36 Navy suicides this year, last year at this time there were just 24 with 43 for the entire year. I wonder if that has something to do with pushing people into an often uncaring bureaucratic system that is more concerned with saving money than meeting the needs of patients.

I was talking to a friend, an officer at the Medical Center today while at a different clinic where I am treated with great compassion, care and dignity, a clinic that is not afraid to get me the medical help that I need, even though it is expensive. This officer and I served at Portsmouth together back in 2008-2010 and that officer told me today that the place has changed. He said it was all about business, impersonal and machine like, devoted to the bottom line, with lip service being given to actual patient needs by those in senior leadership.

Thank God I won’t have to stay in the military medical system the rest of my life. The good news is that when I retire I get to go to the amazingly proficient VA system for that care. Won’t that be grand?

No it won’t. Not for me or any of the tens of thousands, maybe hundreds of thousands of military personnel with PTSD, TBI or Moral Injury. We’ve all read about the problems in the VA, they are persistent, endemic and won’t change anytime in the near future. That is shameful.

General and former Secretary of State Colin Powell famously said “you broke it, you buy it.” Of course he was talking about Iraq, but the same principle should apply to those who have put their lives on the line during the last 13 years of war and come back broken. It is a moral obligation, it is something that we as a nation promised. The country pledged to care for those who served, and the fact that it is barely a half percent of the population who have served in war for the last 13 years, men and women who now have to fight for the basic care that a civilized, and as the Religious Right likes to call a “Christian nation” should provide as a matter of basic human decency. It is not special treatment that broken veterans deserve, it is simple decency and honoring a commitment that we made as a nation.

Yes I am going “Smedley” here, because war is a racket, and it is a racket that those inside the military, the government and the private sector promote.

I’m sure that I will get some blowback from this from some in the system, but I don’t care. The system is broken and until we as a nation stop bullshitting and admit there is a problem and elect to do something about it won’t get better. The bean counters, war profiteers and bureaucrats need to be held accountable by our elected representatives.

I am going to be contacting the Admiral that commands the medical center as well as my Congressman, and probably the chairmen of both the House and Senate Defense committees because I suspect from what I hear from soldiers, sailors, Marines and airmen around the country that this is not an isolated instance. So, if someone like me, a senior officer still in the system doesn’t do this who will?

I hope that this post will become viral so that our sailors, Marines, soldiers and airmen get the quality care, delivered with compassion and humanity that they deserve. For some it will be a matter of life and death.

Pray for me a sinner.

Peace,

Padre Steve+

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July 22, 2013 · 23:59

Monday Musings: The War at Home

me contemplative

Last week was quite challenging at work with sequester and other things going on. Needless to say I was busy but it was at the same time quite rewarding, though not without pain of seeing a number of people that I know, respect, care for and even love go through their own various hell on earth. That I guess is part of ministry, being connected to people in good times and in bad and even when you have no answers, can provide no healing or effectively change their situation. All I could do in each case was to be there for them, with them and where possible provide assistance however limited.

The events of the week coupled with my own impending transfer to a new duty assignment have left me even more introspective than usual. I have been thinking about those times in my life where things were happening that I had little control of, or where maybe even my my choices or decisions brought about difficult times.

I began to think about the time just before I reported to my current billet. I was still struggling with PTSD and though faith had returned it was still quite fragile. I was selected for promotion on the 22nd of June, my dad died of complications of Alzheimer’s Disease on the 23rd, we had his memorial in California on the 26th and the day before I returned to Virginia I was told that I was coming to Camp LeJeune and that I had no choice in the matter. Promotion sometimes brings unexpected change.

At the time I really didn’t want to come. I wanted to finish my last year at the old billet and move on to a ship or possibly something that would get me to Afghanistan, where I believed that I would be “back in the fight.” Instead I went from one hospital serving as a staff chaplain to another serving as the director of Pastoral Care. It was a move up, but not the one that I wanted.

However I was in the front lines, just in a different way. Camp LeJeune and the Marines and Sailors who serve aboard it has been part of the war since the beginning. We have many wounded warriors, men and women, wounded in mind, body and spirit. To see the young men and women with prosthetic limbs, walking in pain with canes or crutches, others with facial disfigurement, blindness, massive scars from burns is humbling. To see these young men and women wearing the Purple Heart Medal, or awards with a “V” device for valor in combat action is truly humbling. To see others suffering in mind and spirit, many struggling with PTSD, TBI, and dealing with various forms of depression, despair and sometimes succumbing to alcohol or drug abuse, including prescription pain medications for chronic pain and even attempting or completing suicide has shown me that the effects of war extend far beyond the battlefield and that this war will go on far longer than the wars in Iraq or Afghanistan.

Major General Smedley Butler wrote in 1932:

“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.” 

Yes this will be with us a very long time.

In a sense I was again in the front lines, this time seeing a part of war that will need to be addressed for a very long time. It has made me much more sensitive to the victims of war and suspicious of people who have no “skin in the game” who constantly advocate war as first response. This will be with me and influence my life and ministry for the rest of my life even after I retire from the Navy in a few years.

I am down to a few weeks left in this assignment before I go to teach mid-grade and senior officers going on to important Joint billets, men and women who have been likewise in the fight for the past dozen years and many of whom will rise to senior leadership before their careers are over. It is a once in a lifetime opportunity. I hope to make the most of it.

Anyway, I have an earlier than normal day tomorrow I shall close for the night.

Until tomorrow,

Peace

Padre Steve+

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March 19, 2013 · 23:32

A Memorial Service as Tragedy Strikes Camp Lejeune on the 10th Anniversary of the Beginning of the Iraq War

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“God didn’t put us here for that pat on the back. He created us so he could be here himself. So he could exist in the lives of those he created, in his image.” Chaplain (Captain) Fr Francis Mulcahy M*A*S*H 

The past week has been difficult at Camp LeJeune. We lost a sailor, a hospital corpsman who died by his own hand last Monday. He was a veteran of Afghanistan and his death came as a surprise to his friends, family and shipmates. Today we conducted his memorial service. It was a full house. His family travelled to be here and his friends, those that served with him while he was assigned to the Marines as well as his current shipmates were there in abundance.

It was a time to grieve. The young man was beloved by his friends, respected and cared for. However something that none of us will ever know or understand overwhelmed him. It may have been the trauma of war, maybe something else, but he maintained a facade that kept his friends, family and shipmates away from whatever despair drove him to take his life.

It was a time for all of us to grieve. It was as William Shakespeare wrote in McBeth a time to “Give sorrow words; the grief that does not speak knits up the o’er wrought heart and bids it break.”

But even as we grieved the news filtered to the base that 7 Marines assigned to the Second Marine Division were killed, and a number of others injured when a mishap occurred where they were training in Nevada. Evidently either a mortar round either exploded in the tube or as it was being handled during a live fire exercise. They join the thousands of men and women who have died or been wounded in preparation for, the conduct of or the aftermath of their service in Iraq or Afghanistan. The death of each one leaves a void in the heart of a loved one, friend or shipmate.

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Staff Sergeant Ergin Osman KIA Afghanistan

I have lost friends and shipmates in all phases of both wars and their aftermath. Some have died in combat, others while supporting combat operations of natural causes or accidents, some have committed suicide, including a Priest and Chaplain who served in both Vietnam and Iraq. Still countless others endure injuries or illnesses that will eventually kill them.

Likewise there are far too many more who have sustained terrible injuries to their minds, bodies and spirits that time will never heal. The young men and women that I see every day, those with the physical wounds of war and those with the unseen but sometimes even more disabling injuries such as PTSD, Traumatic Brain Injury or Moral Injury remain in the fight, sometimes with the sole mission of recover or remaining alive.

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Ten years after the war in Iraq began and twelve and a half years after 9-11 and the invasion of Afghanistan the costs continue to build in lives and treasure. In Iraq almost 4500 American and over 300 other coalition casualties, more than 500 contractors and nearly 10,000 Iraqi Soldiers and Police and countless thousands of Iraqi civilians have died. US wounded alone number almost 35,000 in Iraq. In Afghanistan there are over 2100 US dead and about 1100 NATO and Coalition dead, hundreds of contractors, and thousands of Afghans with over 17,000 more American military wounded. Every day nearly 20 veterans take their lives while thousands of others struggle with physical, psychological and spiritual wounds of war, wounds that don’t heal even as they find that they no longer fit in the country that went shopping when they went to war. The costs of both wars now are building into trillions of dollars, costs that will continue to grow even after the wars wind down.

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Two time Congressional Medal of Honor Winner Major General Smedley Butler, US Marine Corps wrote:

“What is the cost of war? what is the bill? Major General Smedley Butler wrote: “This bill renders a horrible accounting. Newly placed gravestones. Mangled bodies. Shattered minds. Broken hearts and homes. Economic instability. Depression and all of its attendant miseries. Back -breaking taxation for generations and generations. For a great many years as a soldier I had a suspicion that war was a racket; not only until I retired to civilian life did I fully realize it….” (See War is a Racket: Remembering Major General Smedley Butler USMC and Why He Matters ) 

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Likewise Lieutenant General (US Army Retired) Hal Moore, who is immortalized in the film We Were Soldiers and book We Were Soldiers Once…and Young told West Point Cadets in 2005:

“The war in Iraq, I said, is not worth the life of even one American soldier. As for Secretary Rumsfeld, I told them, I never thought I would live long enough to see someone chosen to preside over the Pentagon who made Vietnam-era Defense Secretary Robert McNamara look good by comparison. The cadets sat in stunned silence; their professors were astonished. Some of these cadets would be leading young soldiers in combat in a matter of a few months. They deserved a straight answer.

The expensive lessons learned in Vietnam have been forgotten and a new generation of young American soldiers and Marines are paying the price today, following the orders of civilian political leaders as they are sworn to do. The soldiers and those who lead them will never fail to do their duty. They never have in our history. This is their burden. But there is another duty, another burden, that rests squarely on the shoulders of the American people. They should, by their vote, always choose a commander in chief who is wise, well read in history, thoughtful, and slow-exceedingly slow-to draw the sword and send young men and women out to fight and die for their country. We should not choose for so powerful an office someone who merely looks good on a television screen, speaks and thinks in sixty-second sound bites, and is adept at raising money for a campaign.

If we can’t get that part right then there will never be an end to the insanity that is war and the unending suffering that follows in war’s wake-and we must get it right if we are to survive and prosper as free Americans in this land a million Americans gave their lives to protect and defend.”

Needless to say, Moore, a West Point graduate has not been asked back.

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Thousands of young Americans, as well as NATO or other Allied nation soldiers, including Iraqi soldiers that I knew and Afghans that I have not worked with have died or been mangled by these wars. Yet too many Americans, Europeans and others that have sent young men and women to these wars have no stake in the game.  Most people continue with the mundane aspects of peacetime life while their political, religious and business leaders plot even more war. Syria, Mali, North Korea, Iran…where will it end?

Today we mourned a shipmate and friend at Camp LeJeune even as we wait to see who else that we know have been killed or injured in this latest training accident. I was honored to be a part of the memorial and happy to be of help to the families and friends of my sailor. At the same time I too grieve and wonder just how many more will have to die before the madness ends.

I left the base after the ceremony, and saw the massed trucks of the local and national news networks parked outside the gate like vultures. When I got home I hugged my dog Molly, I love that little dog, she has helped save my life after my time in Iraq. I then went for a four mile run on the beach and then had a couple of beers with my dinner while at the bar with my friends at my local watering hole.

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The old regulars there have nicknamed me “Father Mulcahy” a name that some people at the hospital have also given me. Maybe it is that I ear round steel rimmed glasses. Maybe it is because I will join in the occasional poker game , football, basketball or NASCAR pool, which by the way I won the NASCAR pool this week. Or maybe it is just because they didn’t know I was a Chaplain or Priest until a mutual friend and co-worker told one of them. Until then I was just Steve, the guy that wore the Orioles and Giants baseball gear. Now I have become their Priest and Chaplain, funny how that works. Regardless, it is a nickname that I cherish, because when I was growing up Fr Mulcahy symbolized so much of what I thought was good in a Priest and Chaplain. The writers of M*A*S*H made him very human. But I digress…

As we mourned today I was reminded of something that Helen Keller said, something that I think no matter what any of us grieve is true. “We bereaved are not alone. We belong to the largest company in all the world–the company of those who have known suffering.”

Pray for me a sinner.

Peace

Padre Steve+

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January 25, 2013 · 22:11

Transitions in the Military: New Assignments

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In the Navy, as well as most military branches in the United States the officer community regardless of their specialty have branch, corps or specialty managers. These men and women work with the services and the individual officers to fill assignments. In the Navy these men and women are called “Detailers” and the process of assignments called detailing.

This afternoon I received a call from my detailer. I am coming up on my “projected Rotation Date” or PRD in October and have been negotiating for orders. The process was disrupted by some other changes in the system and I have been waiting a bit longer than normal to find out what I would be doing next.

In my last two assignments I had no choice. In 2006 the assignment that I thought I had was changed and in 2008 I was requested by name for an assignment at Naval Medical Center Portsmouth and in 2010, a year before I expected to rotate and less than a week after I had been selected for promotion to the rank of Commander I was informed that I would be assigned as the Command Chaplain at the Naval Hospital Camp Lejeune North Carolina. I have now completed most of that tour and was awaiting word.

What I wanted to do was to teach and be the Chaplain at the Joint Forces Staff college in Norfolk. It has been an assignment that I have wanted for a number of years. It combines being an instructor in Ethics for students from the Army, Navy, Marines, Air Force, Coast Guard and foreign officers attending the courses at the college, as well as having chapel responsibilities. However I was told a couple of months ago that the assignment was going to another chaplain. I was disappointed because it was a billet that I thought that I was uniquely qualified.

I had spent 17 1/2 years in the Army, been a company commander as well as battalion, group and brigade staff officer before becoming a chaplain. Additionally my military and civilian education which include the Marine Corps Command and Staff College and a Masters Degree in military history and some rather unusual assignments including a joint tour in Iraq as chaplain to American advisors in Al Anbar province as a member of the Iraq Assistance Group, made me, at least in my opinion an ideal choice.

However as of a couple of months ago the billet was already filled. Thus I had no idea what assignment that I would get and since there were very few assignments available in my detailing “window.”

I was expecting a call in the next week or so, but I did not expect the detailer to tell me that I would get the Joint Forces Staff College job. I am happy to get it. It will mean that I will return to the Norfolk area in the September-October time frame. The position will allow me to teach in a very interesting setting as well as pastor the chapel congregation.   It will also allow me to continue my academic education and writing. It will also allow me to be at home after a three year tour away from my wife Judy. For that I am most grateful.

Since it is a non-deploying billet it probably will not help my chances too much to make Captain in a view years, but that is not my goal. My goal is to be at the place where I can do the most good, take advantage of my skills and experience and which will challenge me to continue to grow as a human being, priest, chaplain and Naval officer.

It is good news and I am happy that the detailers and senior leadership honored my request for the assignment. The timing allows me to finish well where I currently serve and contribute the the continuing mission of healing the minds, bodies and spirits of Marines and Sailors, including those wounded, ill or injured in war at Camp LeJeune.

It is a good day.

Peace

Padre Steve+

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February 17, 2012 · 23:37

A Memorial Service for HM1 David Graney and the End of a Long Week

This has been a busy week. It began with an unexpected emergency to baptize the grandchild of a dear friend injured in a terrible household accident.  I drove from North Carolina on Sunday to Virginia Beach and returned Monday evening. When I returned I was getting ready and preparing for the memorial service for a shipmate who died just two months from retirement, a service that we conducted today. After the service I was able to drive back to see my wife Judy and our nephew Adam, an Army Sergeant who is taking a course at Fort Lee and who is visiting for the weekend.

I am tired but blessed. Despite the hectic schedule I do love what I do and the people that I have the honor of serving.  Today was no exception as I had the honor of conducting the memorial service for Hospital Corpsman First Class David Graney, a Cardiovascular Technician at Naval Hospital Camp LeJeune.

David was preparing for retirement and was just two months away from when he would retire when he passed away. He was beloved among his fellow sailors, a mentor, friend, shipmate and leader. He was so knowledgable about his work that many people that he met in professional settings assumed that he was a fellow Cardiologist and not a technician who was attending conferences with the Cardiologists that he worked for and with. He was a leader who took care of his sailors teaching, caring and helping. He was a model Corpsmen. He was honest, forthright and did not hesitate to give his professional opinion and had a devastating sense of humor. I did not know him well, I had only met him a few times but from what his friends, shipmates and co-workers said I realized that David was a gem of a human being ad wonderful sailor.

His memorial service was attended by his family as well as former shipmates who travelled from across the country to attend. With our sailors drawn up in ranks in their dress blues David’s friends and shipmates recounted his impact on their lives.  I had the honor of conducting the service as well as preaching the homily.  I was really touched by the words of a young Corpsman who David led, as well as the words of our staff Cardiologist and a Petty Officer who had attended the Cardiovascular Technician course with David. What was consistent was that David was honest, forthright, knew his job, cared about those that were in his charge and was incredibly funny.  His death, sudden and unexpected reminded us all of our own mortality.

David will be missed by all those whose lives he touched. His death tore a hole in the fabric of the community that he served and in his family. I know that I wonder and ask the “why” question when someone like David dies seemingly before he should. Of course the “why” question cannot be answered except that for all of us death is a certainty, but not necessarily the end. Likewise that God will not fill the hole that is left in our lives when we lose someone dear to us. We can try to do it but that is ultimately self defeating because as long as that hole remains we remain connected to the one that we have lost. Dietrich Bonhoeffer said that:

“There is nothing that can replace the absence of someone dear to us, and one should not even attempt to do so. One must simply hold out and endure it. At first that sounds very hard, but at the same time it is also a great comfort. For to the extent the emptiness truly remains unfilled one remains connected to the other person through it. It is wrong to say that God fills the emptiness. God in no way fills it but much more leaves it precisely unfilled and thus helps us preserve — even in pain — the authentic relationship. Further more, the more beautiful and full the remembrances, the more difficult the separation. But gratitude transforms the torment of memory into silent joy. One bears what was lovely in the past not as a thorn but as a precious gift deep within, a hidden treasure of which one can always be certain.” 

I am tired right now, but have been privileged to be a part lives of the people that I have be able to serve this week. The are friends, they are shipmates, they are family.  They are part of the tapestry of my life.

Tonight I was able to celebrate the birthday of a friend at Gordon Biersch and I will check in on my friend whose grandson was injured while I am home. It should be a nice and hopefully relaxing weekend wit Judy, Molly and our nephew Adam before I return to North Carolina on Monday.

Have a blessed weekend.

Peace,

Padre Steve+

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August 28, 2011 · 23:33

After Irene: What happens the Next Time, do we feel Lucky?

Crews working to restore power aboard Camp LeJeune

Irene has left the scene and thankfully for whatever reason, divine intervention or just plain luck Irene lost her groove and didn’t get it back before coming ashore.  There was damage and loss of life but it could have been much worse.  She had weakened and hit New York at low tide had she not weakened and moved fast New Yorkand much of New Englandcould have faced a disaster of epic proportions.  Even still damages are estimated at 7 billion dollars and there were towns which most people in power don’t really give a damn about that were devastated by flooding, storm surge or wind.

In North Carolinawhen I am stationed we took the brunt of the storm.  There was a lot of damage in the communities where she came ashore, the Outer Banks and in low lying inland areas where the building codes are less stringent than on the coast but it could have been much worse.  A big part of the reason is that we have been abnormally dry and so streams and rivers were low and the ground was able to absorb the heavy rain. I have been through worse here and I’m glad that we did not have a repeat of Floyd were the storm was a high category 2 with massive rains inundating a state that had been saturated by two previous hurricanes.

My Island Hermitage is on Emerald Isle and it is better situated than many communities on the Outer Banks.  Despite this I prepared in earnest and thankfully all the damage I had was a bit of wet carpet which happens every time we get a lot of rain.  I’m told that my home inVirginia Beach came through fine although as in every tropical storm or Nor’easter the lakes in my neighborhood overflowed and flooded the streets.  In past tropical storms and Nor’easters we lot power for extended periods of time.   According to my neighbor who was looking after the house there was only a momentary outage.

For us the storm produced some anxiety. As a geographic bachelor and as a part of essential staff at the Naval Hospital I knew that I would be there for the duration. Since Irene was a massive storm I had Judy secure our home and evacuate on Thursday.  We I made the call Irene was expected to hit as a category 3 or strong category 2 storm with both the Island Hermitage and my Old Virginia Home in the crosshairs.  I veer to caution in such situations, it is far better to over prepare and get lucky than to presume upon God or nature depending on your world view.

I rode out Irene in our Naval hospital with our bare bones essential staff, some of their families, patients and families, women in their last weeks of pregnancy and pets of the staff members forced to be on duty.  We did well, my Commanding Officer told the story in this blog post http://navymedicine.navylive.dodlive.mil/archives/501 .  We lost commercial power early on and were on diesel backup generators the duration of the storm.  After the Friday dinner we were reduced to emergency rations which the main courses have an eerie resemblance to MREs and what staff had brought from home.

I ambled about on my gimpy leg the best that I could and had to resort to using my cane to make my rounds as I went about to staff, patients and family members.  Several babies were born on Friday night and Saturday.  It was a good event and thankfully nothing bad occurred.  A lot of people especially those that had never been through a hurricane or had a spouse deployed overseas found it unnerving. But we did our best. We converted the chapel to a TV room for the kids to watch movies since they had little else to do and almost every television were on non-emergency circuits.  We ran an extension cord to an “essential” plug in our section of the building which allowed this to happen and our hospital American Red Cross office supplied us with DVDs as well as coloring books and games for the kids.

As I have written in previous articles the military, particularly the Navy tends to be more of a family than any civilian employer. We are bound together by our shared experiences of deployments, danger and regular moves and family separations.  We pull together in ways that I have never seen in the civilian world.   It is an honor to serve.  I finally left the hospital late this morning since Emerald Isle did not reopen the bridge that links us to the mainland until today.

Since I have come back online I have seen some comments from various critics of Federal disaster assistance or the actions of governors or mayors of states and cities with large numbers of people in the danger zone, about 67 million Americans I think is the number.  The most critical politicians were from the House of Representatives and the biggest mockers when Irene came ashore in a weakened state and did less damage than expected were from the “new” conservative media.  Having been through more hurricanes and major earthquakes than I can count and seen the devastation of these events and the effects on the lives of people I find the comments calloused, mean spirited and simply used this as another way to push a political agenda.

Of course it is easy to be a critic when you have no direct responsibility for the lives of people.  You see those in the executive branch be it at Federal, State of City levels of government  and the agencies are each level are damned if they do and damned if they don’t.  If they know of something that that could devastate their communities and the citizens in them and do too much and disaster doesn’t strike, those that hate government say that they are overreacting and an “intrusion of big government.”  If they don’t react it is held up as a failure of government.  As far as Federal assistance after an event those that say that the Federal government should let people sink or swim and states and municipalities fend for themselves even if the disaster is overwhelming the same is true.  They are always critical simply because they want to dismantle the Federal government. Well most are against it until it is their community is affected, the rare exception being Virginia Representative and House Majority Whip Eric Cantor who told people in his own district to take a hike after they were hit by an earthquake that no one ever anticipated or were prepared.

Close to 70 million people were potentially at risk from a potentially historic hurricane that only weakened at the last minute.  The President, the governors of the affect states and the mayors of major cities did what they were supposed to do.  They did not wait until it was too late as was the case in Louisiana and Hurricane Katrina.  For that they are mocked I the press, especially those that are deemed liberal I haven’t heard any criticism of the actions of Republican Governors of Virginia or New Jersey for doing what the Mayor of New York did.

We got lucky this time but some day we won’t be and if the critics have their way the result will be historic in the bad kind of way, think about the Tsunami in Japan kind of bad.  We got lucky and if we think of ourselves as gamblers we need to remember that eventually the law of averages works against us, just ask the people of New Orleans or more recently Joplin Missouri.  God or nature take your pick only gives us so many chances and it takes only one of these things to make a direct hit and wipe untold numbers of people, their communities and even the assets of major corporations and Fortune 500 companies, but then the people that are against Federal assistance to regular people would jump through their asses to help Corporate America, can you imagine what would have happened in Wall Street went under like they did back in 2008 except this time under real water?

Being prepared and taking precautions is always preferable to loss of life on a major scale.  No government or community can be prepared for all contingencies but it is foolish for them not to do so but they are damned if they do and damned if the don’t in the eyes of their critics do not have the same responsibility.

I do hope that we band together to help those most affected by Irene and other recent disasters.  Prayer is nice but action is even nicer. Thank God there are good people that lay it all out for those in need and do it well working with the government and other charitable organizations and individuals. I think a lot about the efforts of the Southern Baptist disaster response teams as well as the Salvation Army disaster relief and those like them that make such a difference.

I’m glad that Irene lost her groove and didn’t get it back, unfortunately lives were lost and millions of people have suffered some kind of loss due to her.

After the Storm

For me it was a long and exhausting event. But it was a great chance for me to have a weekend with some wonderful people, my local Navy and Marine Corps family.  Men and women that give every day and exemplify the best of America.  That makes all the difference.

Peace,

Padre Steve+

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May 3, 2011 · 23:51

Full Military Honors: Getting a Chance to Repay a Service done for My Family by the Navy

Last summer my dad Aviation Storekeeper Chief Carl Dundas died after a long battle with Alzheimer’s disease.  Since I wasn’t much good for anything then my boss at my last duty station Chaplain Jesse Tate contacted the Chief of Chaplains Office and our mutual friend Chaplain Jerry Seeley in California.  These men and the Navy came through to provide my family with a funeral with full military honors for my dad.  It was something that we all treasured and something that really helped my mom get through that dark time. It allowed her to reconnect with the Navy something that was a big part of our lives for years. I won’t forget Chaplain Seeley and his comforting words and the Senior Chief Petty Officer who presented our Nation’s Flag to my mother.  One thing that I did do was construct two collages of pictures from his life which were available for friends and family to view. When I put them together it was really for my mom but the task of sorting through a couple of thousand photos to find the ones that best epitomized my dad, his life and personality was healing to me.

Since I am a Chief’s kid I have a soft heart for Navy Chiefs and in the past two and a half years working in Navy Medicine I have been able to be with quite a few of these men and women in their final days as well as their families. Last week I had the duty pager and received a call to come to our multi-service ward as a family had requested a baptism for one of our former Master Chief Petty Officers named Carl.  He and his family had arranged with one of my staff to be baptized last Friday as he knew his life was coming to an end.  Well late Wednesday night it became apparent that he would not last that long and I was asked to come in.  I got to the hospital and put on my Khakis and went to the nurse’s station where I listened to them tell me the situation and read his chart. I noted the request for baptism and the plan for it to be done Friday.  When I had done that I went to the room where Carl lay in bed dozing. I met his wife Judy and son’s Randy and Jeff and we visited for nearly an hour as he lay there and I listened to them tell me about him as a husband and father, his Navy service, his faith and his love for baseball.

Carl had entered the Navy a couple of years after my dad and remained in it a good deal longer retiring in 1988.  He served in combat as a Corpsman with the Marines in Vietnam and saw service around the world. He retired as the Command Master Chief of Naval Hospital Camp LeJeune.  He was active and played for and managed various Navy Baseball and Softball teams including the hospital’s team which I now play on.  There were a lot of emotional connections for me with this man. He served during the era that my dad did and both served on the ground in Vietnam.  His name was Carl like my dad, his wife Judy like my wife and one son Jeff like my brother.  He loved baseball.  I felt like I was family and in a sense I was because we are part of the Navy family and that is something that is special. I still receive e-mails from one of my dad’s former Chief Petty Officers almost like he is trying to watch out for his friend and fellow Chief’s son.

I prepared to conduct the baptism and Carl woke up. His wife introduced me to him and he greeted me. I explained that I was there to baptize him and asked if he still desired to be baptized and he replied yes and gave me a “thumbs up.” As I baptized him he was praying with a smile on his face as the water flowed over his forehead. I then asked for Carl and his family to join me in the Lord’s Prayer and as we prayed he prayed along with us.  It was a special moment and I elected to stay with the family for a while longer and simply be with them as they shared and ministered to Carl.  I gave Judy my card and went home getting to bed about three AM Thursday.

Yesterday afternoon I received word that I had been asked to conduct his funeral and I was honored. It was like having a chance to repay the generosity given to my family by the Navy.  This morning it seemed that nothing went right in trying to get my stuff together. We are in temporary office spaces as our offices and Chapel are being renovated. As a result I have no earthly idea where half of my things are. I prepared my Service Dress Blue uniform last night and placed it where I wouldn’t forget it. I discovered that I didn’t have it about 5 miles into my trip and had to go back and get it. Then on my second trip in about the same place I had the feeling that I had forgotten something else.  I looked around the car and couldn’t find my Bible and Book of Common Prayer.  I thought I had packed it and taken it home with me last night so I turned around again. I got home to the Island Hermitage and try as I might I couldn’t find them.  So I grabbed the Kindle that my Judy had got me for my birthday knowing that I had the Book of Common Prayer and the liturgy for burial on it.  I got back on the road for the third time and arrived at the office where I found my Bible and Book of Common Prayer.  I then started to get ready to go after a bit of business and discovered that I had everything but a tie, which I only have about five of but none were to be found. Our small Marine Corps Exchange in the hospital had none so I had to go to main side where I got one of the two on the rack; this is a Marine Corps Uniform store so the Navy items are not well stocked.  Getting back to the office I donned my uniform looking perfectly resplendent I might add and went to the funeral home where I met up with other perfectly resplendent Chiefs and Sailors.  One thing about the Navy Service Dress Blues they are a classic uniform and are always a classy look.

We had a significant number of sailors there with members of our Chief’s Mess acting as pallbearers, other Petty Officers and Sailors serving as the Flag detail and one of our Master Chiefs presenting the American Flag to Judy.   We also had about 30 other Sailors present joining Carl’s family, his extended family and friends which included a number of men who had served with Carl during his career.  A Marine Honor Guard commanded by a Gunnery Sergeant fired the 21 gun salute and then Taps was played.  It was an honor and privilege to participate.

The brief homily that I gave came out of the Gospel according to John where Jesus tells Martha at the tomb of Lazarus “I am the resurrection and the life.”  In it I focused on that message even as I mentioned his service, life and care of his family and his sailors and his service during and after Vietnam.  After the committal I lingered with various friends of Carl’s and as the crowd dissipated I got into my car and left.  I was blessed by God to be able to return a favor done to my family.  For me this is a large part of why I continue to serve, to care for God’s people in the Sea Services those currently serving and those that blazed the trail for us.  Sometimes one gets lucky.

Peace

Padre Steve+

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November 17, 2010 · 01:23

PT and Bumping into Old Friends at Camp Swampy and Getting Carded at Applebee’s

The Main Gate at Camp Swampy

One nickname that Camp LeJeune North Carolina bears is “Camp Swampy.” This is because of the marsh like conditions of some of the base, the normally abundant rainfall and the propensity of said rainfall to accumulate wherever it falls. It is somewhat like the Tidewater, a polite name for “swamp” is in Virginia, only with more rain and in the spring and summer the humidity, mosquitoes and other vermin that love the conditions.  However, because it is a Marine Corps base one can find people doing PT at any time of the day or night in a variety of forms.  Of course the Marines at Camp LeJeune PT in any weather and Chaplains assigned here, even those with the Navy are kind of expected to do the same. Of course each Chaplain does so within his or her physical constraints. Despite being 50 years old I am still in pretty good shape and have the psychological need to try to keep up with people 20 to 30 years my junior so when I do my PT I am serious about it.  In fact when I was stationed with Navy EOD I did so well on the physical readiness test that an EOD tech asked my assistant Nelson Lebron “what kind of ‘roids is the Chaplain on?”  I found this funny since I don’t do this but I can tell you at the age of 50 and being subject to all sorts of minor bumps, dings and nagging injuries I can understand why some professional athletes would use substances such as HGH, but like the rest of the Navy-Marine Corps team I survive on “Vitamin M” or as it is commonly known to laypersons as 800 mg Motrin.

My normal or abnormal regimen is to do what I call “distance interval training.” Interval training usually entails combining some kind of cardio with exercises that work various muscle groups interspersed throughout. I first did interval type training in high school football practice, back then we called them “grass drills” where we ran in place and whenever the coach blew his whistle we would drop for pushups, sit-ups, flutter kicks or any other exercise that could put us on the ground.  I saw a variation with the Marines early in my Navy career that entailed sprinting and then dropping for whatever kind of punishment the leader determined.  Back then I preferred to run long distances up to 20 miles in training for half-marathons and marathons.

However a series of nagging overuse injuries took me down to 5-8 miles a run before I went to Iraq. In Iraq I picked up a few more injuries and it took me a while to recover so after I was assigned to Naval Medical Center Portsmouth I built my runs back up to 3-5 miles but I didn’t find that this was working for me anymore. So I went back to something that I hadn’t done since high school, interval training but I didn’t want to give up running.  I devised a plan that works for me and what I need it to accomplish.  I am now adding the P90X fitness program to fit in on alternate days.

Now I run about 3 miles but every 100-200 yards I drop for a set of 15-25 pushups get up and then do one of 5 different sets of abdominal exercises, 15-30 regular crunches, 40 oblique’s, 15-20 crunches with legs up at a 90 degree angle, 60-100 bicycle crunches and 50-100 flutter kicks with sets of pushups between each of them.

With Paul Rumery in Sicily, he has the hair

It has taken me a while to get settled at Camp LeJeune and begin to plan safe routes to run this and I am just getting back into the groove. Today I went out at lunch amid threatening rain. About a third of the way into the workout the rain came down and I continued to run, the rain was actually quite refreshing and by the two third point of the run I was soaked, my orange Baltimore Orioles t-shirt and gray running shorts must have weighed 5-6 pounds.  As I got up from a set of crunches I wiped off my sunglasses, no I didn’t need them I just like to look cool and as I wiped them off on my previously mentioned soaked Orioles t-shirt I started to run and a car pulled alongside where I was running, the window rolled down and I heard a familiar voice, LCDR Paul Rumery, the Chaplain who had relieved me on USS Hue City in 2003 and who had taken me to dinner the last time I was in Sicily with EOD called out “Hey Steve wild man I knew that it had to be you!” I pulled up and went over to the car, we had a brief talk. Paul had a brand new Chaplain with him who he told that I was a “wild man.” Paul let me know that he didn’t know that I was aboard Camp LeJeune and said that we needed to get together.  It was good to see him and I hope that we do get together soon. I picked up the run again and took it back in to the hospital where my now squishy running shoes and waterlogged clothing dripped of my mud stained body. A Marine Staff Sergeant came up to me and said that I had leaves on the back of my head. I laughed, said “I’m not surprised” and commented “if it ain’t raining we ain’t training.” The Staff Sergeant asked about my workout and was suitably impressed. I then ran into a Corpsman who had been assigned with me at 3rd Battalion 8th Marines back in 2000-2001.  He and I talked for a while. It’s funny what a small world it is when you are stationed in a place like Camp LeJeune.

After work I stopped by the local Applebee’s for a beer and a burger and I was carded by the server. I thanked the server who told me that they and to card anyone that looked under 30 and when he saw my ID and age he was surprised. I must say that since there are so many Marines and Sailors here it is not uncommon to be carded and since I don’t dress my age I can see why I get carded. I must say that it appeals to my vanity.  I guess part of this must be due to good genes as well. Whatever it is I will take it.

Tomorrow I will drive up to Virginia as I have a specialty appointment and assessment to figure out what might be causing my auditory processing disorder.  I haven’t understood speech well since returning from Iraq and the additional Tinnitus is at times deafening.  Hopefully they will figure it out and find something that will make it better.

So anyway, until tomorrow….

Peace

Padre Steve+

 

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November 3, 2010 · 18:18

A Base at War: First Impressions of Camp LeJeune Nine Years after my First Tour

This is just a brief post on some first impressions on my assignment to Camp LeJeune after a nine year absence from the base. When I left LeJeune and my assignment with the Second Marine Division I had just completed twenty years in the military though I was not even three years into my service as a Naval Officer.

Today I was part of a Casualty Assistance Team meeting with the family of a young Navy Corpsman and Afghanistan veteran who killed himself in his apartment last night.  The Corpsman was part of a family with a long tradition of Naval Service who in his time in the Navy had gone to war with a Marine Battalion in Afghanistan’s Helmand Province and returned home changed by the war and struggling with PTSD and all the related symptoms of it.  This is something that I can understand having come back from Iraq in a rather bad way about two and a half years ago.  In my time with this young man’s parents today I found a young man that loved life but was wracked by his experiences of war.  He was well liked at his Marine Battalion as well as at the hospital and his death shocked the community almost as much as it did his family.  The sad thing is that this young man is emblematic the suicide problem in the military.  He is not alone, far too many Soldiers, Sailors, Marines and Airmen on active duty, in the Reserves or those that have left the service suffer so much from the unseen wounds of war that they commit suicide.  Since I have been here just a bit under two weeks this was a confirmation of what I knew just walking around the hospital, getting around the base and the local area.  Camp LeJeune is a base at war with Marines and Sailors fighting in Afghanistan and unfortunately many suffering from deep wounds of war at home living with physical, psychological, spiritual and moral injuries that don’t go away just because they return home.

When I left LeJeune in compliance with orders to the USS Hue City CG-66 in December 2001 we were just 3 months into the current war and barley two months into the Afghanistan campaign.  Marine morale was high though most Marines had not been to combat and those that had were veterans of Operation Desert Shield and Desert Storm, Somalia or the Balkans. Of course none of these actions lasted as long nor caused the amount of deaths as either the campaign in Iraq or Afghanistan.  Marines wanted to get a shot at the Al Qaeda terrorists that had attacked the United States and killed nearly 3000 Americans.

The Marines answered the call and have performed magnificently in every theater of the current war but the Corps has changed. Back in the late 1990s and early 2000s the Marines had a swagger that was typical of the work hard; train hard and play hard attitude of the Corps.  The Corps is now composed of many battle hardened veterans that have made deployment after deployment to the hottest combat zones in both Iraq and Afghanistan in which they took the initiative in both offensive operations in taking the battle to the enemy and employing solid counterinsurgency techniques especially in Al Anbar Province where the Iraqi Army performed quantitatively better under their tutelage in helping to turn the tide during the Anbar awakening.  Navy Corpsmen, Doctors and Chaplains serve alongside the Marines as they have done throughout our history.

I served with Marine and Army advisors in Al Anbar in 2007 and early 2008 in many of the remotest parts of the province and have dealt with individual Marines since. The Marines still have much of their swagger but it seems more fatalistic now.  An expert in trauma and moral injury told me of a recent visit to Camp Pendleton where Marines referred to themselves as “the walking dead” in an almost cavalier manner. The sad thing is that for many Marines this is only half a joke. The Corps in 2009 had the highest suicide rate in the military at 24 per 100,000 and suicides continue at a similar pace in 2010.  http://www.yuma.usmc.mil/desertwarrior/2010/03/11/feature6.html One occurred on Camp LeJeune where a Marine Sergeant pulled out a pistol and shot himself after being pulled over by Military Police in front of the base Fire Station.

As I made my way around the base the past week or so, I saw a lot more Marines with canes and obvious physical injuries from their combat injuries incurred in Iraq or Afghanistan. The Marines as always were professional but appeared to be much more serious than 9 years ago, many seeming to be old beyond their years. I love serving with and around Marines because they have a unique sense of professionalism combined with humor that is unlike almost any found in any part of the United States Military. However that positive is sometimes offset by a need to maintain an image of toughness even when they are dying on the inside which leads many not to seek help because it might make them look weak or broken, terms that no self-respecting Marine wants associated with his or her name.

In addition to the obvious injuries I noticed that while there was a much more serious tenor around the base that the Staff Sergeants and Gunnery Sergeants are a lot younger than they used to be back 9 years ago. With the war lasting as long as it has and the coupled with the expansion of the Marines during the war coupled with casualties and attrition by other means these young men and women are being promoted sooner than they were in the prewar days. Their leadership experience is mostly combat-related and they are in general superb combat leaders. However, this does not always translate well in a garrison setting especially if they are dealing with their own untreated PTSD or TBI nor is it helpful on the home front. As a result many of these young leaders are suffering the breakups of families at a record rate as well as substance abuse when they return home.

As Secretary of Defense Robert Gates noted in a speech at Duke University on September 29th of this year:

“There are a number of consequences that stem from the pressure repeated of deployments – especially when a service member returns home sometimes permanently changed by their experience.  These consequences include more anxiety and disruption inflicted on children, increased domestic strife and a corresponding rising divorce rate, which in the case of Army enlisted has nearly doubled since the wars began.  And, most tragically, a growing number of suicides.

While we often speak generally of a force under stress, in reality, it is certain parts of the military that have borne the brunt of repeat deployments and exposure to fire – above all, junior and mid-level officers and sergeants in ground combat and support specialties.  These young men and women have seen the complex, grueling, maddening face of asymmetric warfare in the 21st century up close.  They’ve lost friends and comrades.  Some are struggling psychologically with what they’ve seen, and heard and felt on the battlefield.  And yet they keep coming back.” http://www.defense.gov/speeches/speech.aspx?speechid=1508

These young men and women have forged a bond in combat and in many cases multiple combat tours. The have served well with honor and many don’t feel that people who have not been “in the shit” understand them or what they have been through.  There is a comradeship that comes out of war. There is segment at the end of the Band of Brothers mini-series where a German Commander is speaking to his soldiers after they have surrendered to the Americans. As the German Commander speaks to the survivors of his unit Corporal Joe Liebgott is asked to translate by another American. As he translates the German officer’s words the Americans know that he also speaks for their experience of war:

“Men, it’s been a long war, it’s been a tough war. You’ve fought bravely, proudly for your country. You’re a special group. You’ve found in one another a bond that exists only in combat, among brothers. You’ve shared foxholes, held each other in dire moments. You’ve seen death and suffered together. I’m proud to have served with each and every one of you. You all deserve long and happy lives in peace.”

I think that sums up what many feel today except unlike the Germans our war drags on with no end in sight.

The Marines are still tough and a force to be reckoned with on any battlefield. They, especially the Marine Divisions are an elite force but I believe that many are losing some of their resilience as the war goes in Afghanistan goes on.  Many from reports that I have read as well as those that I have talked with are concerned that much of the country doesn’t support the war nor appreciate their sacrifice. Many are concerned that their sacrifices as well as those of their friends, those killed and wounded will be wasted and the suffering that goes on after the war will be swept aside by politicians, the media and the public at large. They are also concerned that the people that they have worked with against the Taliban and Al Qaeda in Afghanistan and those that they have tried to protect and care for will suffer even more if the Taliban return to power.  I can say that I worry about my Iraqi friends and fear for them when I hear news of more attacks.

In the midst of this war we went through a number of elections and it troubles me that in the last election that the war and those fighting it were hardly ever mentioned by candidates from either party.  We mentioned it was usually for show to help politicians gain favor with voters.  We deserve better, we are not just a something to talk about at political rallies that when the election is over simply budget item to be slashed because the country is in a mess. These young men and women, as well as old guys like me are the sons, daughters, husbands and wives and brothers and sisters that have volunteered to serve this country.  The wounds that these young men and women, their experiences in combat that have left their souls scared will not go away when the last American leaves Iraq or Afghanistan.

This young man that we lost last night will be buried by his family and we will have a memorial service in his honor.  His many friends will grieve and those of us who are caring for his family will not forget them. I don’t want this young man or any other to be forgotten like so many who have returned from war before them.

Peace,

Padre Steve+

 

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September 29, 2010 · 23:58

Suicide isn’t Painless: The Epidemic of Suicide in the Military

I leave the Naval Medical Center Portsmouth Virginia tomorrow and toward the end of October report as the Command Chaplain for Naval Hospital Camp LeJeune North Carolina. My last time at Camp LeJeune was as part of the Portsmouth SPRINT (Special Psychiatric Rapid Intervention Team) mission to care for Emergency Department personnel at the Naval Hospital and Base Fire/EMS responders to a particularly gruesome suicide of a young Marine who had recently served in Iraq and was preparing for another tour.

As a Chaplain and in my previous life as a Medical Service Corps officer commanding a Medical Company in Germany and Brigade Adjutant in Texas I have dealt with a lot of suicides, attempted suicides and the lives left shattered by suicide.  Likewise I have seen the results of suicide attempts as a trauma, emergency and critical care chaplain in major medical centers. I have attended the DOD Suicide Prevention Conference on a number of occasions and gotten to know many of the experts working in the field.

As I said I began my career as an officer in the Army Medical Service Corps. We had a close connection to the movie and television series M*A*S*H and the theme music to that movie is emblematic of the feelings of many combat vets who continue to deploy even after making many combat deployments. http://www.metacafe.com/watch/3444418/suicide_is_painless_johnny_mandel/

Through early morning fog I see
visions of the things to be
the pains that are withheld for me
I realize and I can see…
[chorus]:

That suicide is painless
It brings on many changes
and I can take or leave it if I please.

I try to find a way to make
all our little joys relate
without that ever-present hate
but now I know that it’s too late, and…
[Chorus]

The game of life is hard to play
I’m gonna lose it anyway
The losing card I’ll someday lay
so this is all I have to say.
[Chorus]

The only way to win is cheat
And lay it down before I’m beat
and to another give my seat
for that’s the only painless feat.
[Chorus]

The sword of time will pierce our skins
It doesn’t hurt when it begins
But as it works its way on in
The pain grows stronger…watch it grin, but…
[Chorus]

A brave man once requested me
to answer questions that are key
‘is it to be or not to be’
and I replied ‘oh why ask me?’

‘Cause suicide is painless
it brings on many changes
and I can take or leave it if I please.
…and you can do the same thing if you choose.

Last week four soldiers, one a highly decorated senior NCO and all combat veterans are believed to have committed suicide at Fort Hood Texas.  The base which has already seen more than its fair share of tragedy with 14 confirmed suicides this year is stunned that these occurred in one weekend.

Defense Secretary Robert Gates commented about the stress on the all-volunteer force: “No major war in our history has been fought with a smaller percentage of this country’s citizens in uniform full-time — roughly 2.4 million active and reserve service members out of a country of over 300 million, less than 1 percent,” as a result the wars have been fought by a small proportion of the country, for many they are “a distant and unpleasant series of news items that does not affect them personally.” While the distance grows between those that serve and the general population military families are under even more stress, with anxiety and disruption inflicted on children, increased domestic strife and a growing number of suicides. Divorce rates in the Army have doubled since the wars in Afghanistan and Iraq began.

In the years prior to about 2004-2005 the military suicide rate was almost always below civilian rates in all demographics.  This is something that we took legitimate pride in.  That began to change as the war in Iraq shifted from a “Shock and Awe” campaign to a rather nasty and intractable insurgency this began to change as the deployment tempo increased and the Army increased its “boots on ground” time from a year to 15 months with a one year dwell time between deployments. Even as Iraq calmed down and the US role shifted many troops remain and Afghanistan has become a much more difficult war than it was even a few years ago. The Marines retained a 6-7 month deployment schedule but as the war went on and personnel requirements increased many Marine units were doing 6 months in country and 6 months home.  The difficult of what was described as “dwell time” for the Army and Marines was that for all intents and purposes it wasn’t. The units would get a few weeks leave and stand down time on their return home and then begin preparing for their next deployment. These preparations out of necessity entailed much time in the field training including trips to the Fort Irwin National Training Center (NTC) or the Marine Corps Air Ground Combat Training Center at 29 Palms.  Speaking from experience before 9-11 I can say that a Marine battalion going to 29 Palms in reality makes a short but intense deployment which is taxing on the organization even as it sharpens combat skills.  The same can be said for Army units going to NTC.  Thus the time that is nominally considered time at home to recuperate is not that and instead serves to keep the pressure on already stressed units, leaders and soldiers/Marines.  In the intervening time those that present to mental health providers or chaplains are provided with care to get them back in shape for the next deployment but never really get to deal with the deeper psychological and spiritual wounds. These include “moral injury”  which often involves unresolved grief for the loss of comrades and real or imagined guilt for their own actions in war.  Such wounds ultimately create despair, loss of faith and eventually cause some service members to make attempts on their life with varying degrees of “success” in “completing” the suicide.

The result is that those who have experienced the moral injuries that come as a result of combat, seeing comrades killed and wounded, participating in actions where they are directly or indirectly involved in killing the enemy, see the “collateral damage” of civilians, including children killed and maimed go right back into to fight.  Since this war has now gone on longer than any war in US history and we are fighting it with an all volunteer force of limited numbers with many making multiple deployments, some as many as 5 or more these wounds are pushed aside.  The effect of this is a cumulative grinding down of those that serve in harm’s way. Many suffer from some form of psychological, neurological or even spiritual injury that in combination with other life stressors make them particularly vulnerable to taking their lives.  In regard to moral injury “Many of the troops kill themselves because they feel that those kinds of experiences have made them unforgivable,” said Dr. William Nash, a top PTSD researcher. “It’s a lot harder for most people to forgive themselves than to forgive others.”

Unfortunately there is a stigma attached to seeking treatment or admitting that one is suffering from depression, anxiety or any other condition associated with either seeking help on their own or being “command referred” for psychological/psychiatric help.  Since that stigma is real many war fighters don’t seek help and take “refuge” in destructive behaviors such as alcohol abuse, drug abuse (to include prescription drugs) and risky behaviors.  One wonders how many of the single vehicle accident fatalities that occur late at night to combat vets are not accidental at all but are suicides by another more “socially acceptable” means.  If a forensic psychological profile was done on every service member that dies in such events I would guess that the finding would be a lot more suicides not an accidental deaths as we would like to believe. Yes all of these deaths are tragic but it is far easier to rationalize death in an auto accident than death by gunshot, knife wounds, overdose or hanging.

I am not proposing any solutions for this problem.  I do believe that somehow the deployment tempo needs to be slowed down to allow troops to actually recover and get help.  This is one of the suggestions of the DOD Suicide Prevention Task Force.  Their report is linked here: http://www.health.mil/dhb/downloads/Suicide%20Prevention%20Task%20Force%20report%2008-21-10_V4_RLN.pdf

When I go to LeJeune I know that as a Chaplain at the Naval Hospital I will be collaborating with our mental health professionals to provide care to Marines, Sailors and their families that are living this daily.  The Marine situation is poignantly show in this article: http://www.nctimes.com/news/local/military/article_3dc03ec3-6a37-5608-8563-aca88f635271.html

I have served with the Marines almost 6 years and from what I see the Corps has changed.  It is battle hardened but less resilient than it used to be.  The Marine Corps’ suicide rate has reached 24 per 100,000, a rate that surpasses all the other services. The rate was 13 per 100,000 in 2006 when I finished my tour at Marine Security Forces. The latest available figures put the civilian suicide rate at 20 per 100,000.  The problem extends past active duty as Veterans Affairs Secretary Eric Shinseki, the former Army chief of staff, said the suicide rate for men aged 18-29 who have been discharged had gone up by 26% from 2005-07. Likewise, “of the more than 30,000 suicides in this country each year, fully 20% of them are acts by veterans.” This means as Shinseki said “on average 18 veterans commit suicide each day. Five of those veterans are under our care at VA. So losing five veterans who are in treatment every month, and then not having a shot at the other 13 who for some reason haven’t come under our care, means that we have a lot of work to do.”

There is also an effect on military health care providers of all kinds and chaplains. These individuals not only have to deal with their trauma but the trauma and hopelessness that they see in many of their patients or parishioners. These caregivers have no respite between deployments because their reason for being is to care for the Soldiers, Marines, Airmen and Sailors that present to them be they deployed or back in a military hospital or clinic.

The work will be hard and long after the last Marine, Sailor, Soldier or Airman leaves Iraq and Afghanistan we will be dealing with this for years to come.

Peace

Padre Steve+

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